Provider Demographics
NPI:1831927326
Name:DAN FIELDS III, DDS PLLC
Entity type:Organization
Organization Name:DAN FIELDS III, DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:DAN
Authorized Official - Middle Name:
Authorized Official - Last Name:FIELDS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:423-994-5228
Mailing Address - Street 1:180 WALNUT GROVE RD
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:TN
Mailing Address - Zip Code:37321-5939
Mailing Address - Country:US
Mailing Address - Phone:423-775-1464
Mailing Address - Fax:
Practice Address - Street 1:180 WALNUT GROVE RD
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:TN
Practice Address - Zip Code:37321-5939
Practice Address - Country:US
Practice Address - Phone:423-775-1464
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-25
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty