Provider Demographics
NPI:1558824813
Name:GUTHRIE DENTISTRY, INC.
Entity Type:Organization
Organization Name:GUTHRIE DENTISTRY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FREDERICK
Authorized Official - Middle Name:V
Authorized Official - Last Name:GUTHRIE
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:423-968-2172
Mailing Address - Street 1:744 BLUFF CITY HWY
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:TN
Mailing Address - Zip Code:37620-4610
Mailing Address - Country:US
Mailing Address - Phone:423-968-2172
Mailing Address - Fax:423-968-1987
Practice Address - Street 1:744 BLUFF CITY HWY
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:TN
Practice Address - Zip Code:37620-4610
Practice Address - Country:US
Practice Address - Phone:423-968-2172
Practice Address - Fax:423-968-1987
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-12
Last Update Date:2019-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty