Provider Demographics
NPI:1467651745
Name:EISENBERG, NICOLE CASE (DDS)
Entity Type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:CASE
Last Name:EISENBERG
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4533 PAPERMILL ROAD
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37909
Mailing Address - Country:US
Mailing Address - Phone:865-410-3075
Mailing Address - Fax:865-674-5122
Practice Address - Street 1:4533 PAPERMILL ROAD
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37909
Practice Address - Country:US
Practice Address - Phone:865-410-3075
Practice Address - Fax:865-674-5122
Is Sole Proprietor?:No
Enumeration Date:2007-07-16
Last Update Date:2018-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS00000080941223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery