Provider Demographics
NPI:1912612755
Name:COSMETIC DENTISTRY OF KNOXVILLE
Entity Type:Organization
Organization Name:COSMETIC DENTISTRY OF KNOXVILLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KASEY
Authorized Official - Middle Name:REED
Authorized Official - Last Name:SLIGER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:865-588-1294
Mailing Address - Street 1:6001 WALDEN DR STE 1
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37919-6355
Mailing Address - Country:US
Mailing Address - Phone:865-588-1294
Mailing Address - Fax:
Practice Address - Street 1:6001 WALDEN DR STE 1
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919-6355
Practice Address - Country:US
Practice Address - Phone:865-588-1294
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-17
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental