Provider Demographics
NPI:1114098209
Name:PITTS, JAMES C JR (DMD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:C
Last Name:PITTS
Suffix:JR
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 W 3RD ST
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:TN
Mailing Address - Zip Code:37347-3218
Mailing Address - Country:US
Mailing Address - Phone:423-942-3334
Mailing Address - Fax:423-942-3331
Practice Address - Street 1:19 W 3RD ST
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:TN
Practice Address - Zip Code:37347-3218
Practice Address - Country:US
Practice Address - Phone:423-942-3334
Practice Address - Fax:423-942-3331
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS8277122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist