Provider Demographics
NPI:1053494609
Name:FRENCH, EDGAR GRAYTON JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:EDGAR
Middle Name:GRAYTON
Last Name:FRENCH
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:705 GATE LN
Mailing Address - Street 2:SUITE 101
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37909-3518
Mailing Address - Country:US
Mailing Address - Phone:865-522-5437
Mailing Address - Fax:865-588-1862
Practice Address - Street 1:705 GATE LN
Practice Address - Street 2:SUITE 101
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37909-3518
Practice Address - Country:US
Practice Address - Phone:865-522-5437
Practice Address - Fax:865-588-1862
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2013-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS20601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN5440284Medicaid