Provider Demographics
NPI:1790355287
Name:PATE, AUSTIN (DDS)
Entity Type:Individual
Prefix:
First Name:AUSTIN
Middle Name:
Last Name:PATE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 W SUMMIT HILL DR APT 201
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37902-1035
Mailing Address - Country:US
Mailing Address - Phone:423-797-1337
Mailing Address - Fax:
Practice Address - Street 1:8912 TOWN AND COUNTRY CIR STE 1
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-4900
Practice Address - Country:US
Practice Address - Phone:865-326-3637
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-28
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN11610122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist