Provider Demographics
NPI:1215039250
Name:KNIERIM, KRISTIN WATSON (DDS, MSD)
Entity Type:Individual
Prefix:DR
First Name:KRISTIN
Middle Name:WATSON
Last Name:KNIERIM
Suffix:
Gender:F
Credentials:DDS, MSD
Other - Prefix:
Other - First Name:KRISTIN
Other - Middle Name:WATSON
Other - Last Name:KNIERIM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS, MSD
Mailing Address - Street 1:601 S CONCORD ST
Mailing Address - Street 2:SUITE100
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37919-3306
Mailing Address - Country:US
Mailing Address - Phone:865-522-7572
Mailing Address - Fax:865-522-6579
Practice Address - Street 1:601 S CONCORD ST
Practice Address - Street 2:SUITE100
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919-3306
Practice Address - Country:US
Practice Address - Phone:865-522-7572
Practice Address - Fax:865-522-6579
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN78681223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics