Provider Demographics
NPI:1457413213
Name:ORWICK-BARNES, SUSAN MARIE (DDS, PC)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:MARIE
Last Name:ORWICK-BARNES
Suffix:
Gender:F
Credentials:DDS, PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10434 KINGSTON PIKE
Mailing Address - Street 2:SUITE 4
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37922-3278
Mailing Address - Country:US
Mailing Address - Phone:865-531-2266
Mailing Address - Fax:865-531-2934
Practice Address - Street 1:10434 KINGSTON PIKE
Practice Address - Street 2:SUITE 4
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37922-3278
Practice Address - Country:US
Practice Address - Phone:865-531-2266
Practice Address - Fax:865-531-2934
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN38071223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice