Provider Demographics
NPI:1689431124
Name:NORTH KNOXVILLE DENTISTRY, PLLC.
Entity Type:Organization
Organization Name:NORTH KNOXVILLE DENTISTRY, PLLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANGER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:HUGHES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-440-1526
Mailing Address - Street 1:225 MAIN ST STE 400
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:TN
Mailing Address - Zip Code:37321-1329
Mailing Address - Country:US
Mailing Address - Phone:865-440-1526
Mailing Address - Fax:
Practice Address - Street 1:120 MERCHANT DR
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37912-3501
Practice Address - Country:US
Practice Address - Phone:865-219-5867
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-01
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental