Provider Demographics
NPI:1437728532
Name:LIVING LIFE DENTISTRY, PLLC
Entity Type:Organization
Organization Name:LIVING LIFE DENTISTRY, PLLC
Other - Org Name:LIVING LIFE DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:KINDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-539-6030
Mailing Address - Street 1:280 FORT SANDERS WEST BLVD STE 117
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37922-3352
Mailing Address - Country:US
Mailing Address - Phone:865-539-6030
Mailing Address - Fax:865-539-6768
Practice Address - Street 1:280 FORT SANDERS WEST BLVD STE 117
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37922-3352
Practice Address - Country:US
Practice Address - Phone:865-539-6030
Practice Address - Fax:865-539-6768
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-22
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty