Provider Demographics
NPI:1801374277
Name:HOLLINGSWORTH, FRED JAMES JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:FRED
Middle Name:JAMES
Last Name:HOLLINGSWORTH
Suffix:JR
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 1:3470 BRANDYWINE DR
Mailing Address - Street 2:
Mailing Address - City:LENOIR CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37772-6844
Mailing Address - Country:US
Mailing Address - Phone:865-661-7290
Mailing Address - Fax:
Practice Address - Street 1:9225 WESTLAND DR # 101
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37922-5216
Practice Address - Country:US
Practice Address - Phone:865-690-0085
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-30
Last Update Date:2018-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN108471223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice