Provider Demographics
NPI:1740322262
Name:DRS CARVER STAKIAS MATHER & SMITH PC
Entity type:Organization
Organization Name:DRS CARVER STAKIAS MATHER & SMITH PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECY TREAS
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:K
Authorized Official - Last Name:CARVER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:423-247-5175
Mailing Address - Street 1:1203 N WILCOX DRIVE
Mailing Address - Street 2:
Mailing Address - City:KINGSPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37660
Mailing Address - Country:US
Mailing Address - Phone:423-247-5175
Mailing Address - Fax:423-247-0019
Practice Address - Street 1:1203 N WILCOX DRIVE
Practice Address - Street 2:
Practice Address - City:KINGSPORT
Practice Address - State:TN
Practice Address - Zip Code:37660
Practice Address - Country:US
Practice Address - Phone:423-247-5175
Practice Address - Fax:423-247-0019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-12
Last Update Date:2009-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty