Provider Demographics
NPI:1831613595
Name:RICH, BRIAN ANTHONY (DMD)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:ANTHONY
Last Name:RICH
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2217 COUNTRY BROOK LN
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37921-2848
Mailing Address - Country:US
Mailing Address - Phone:502-909-7898
Mailing Address - Fax:
Practice Address - Street 1:4820 ASHEVILLE HWY
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37914-4252
Practice Address - Country:US
Practice Address - Phone:502-909-7898
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-02
Last Update Date:2021-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY9990122300000X
TN11414122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist