| Boones Creek Dentistry | |
|
4328 N Roan St Johnson City TN 37615-4641 | |
| (423) 282-2441 | |
| Not Available |
| Full Name | Boones Creek Dentistry |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 4328 N Roan St, Johnson City, Tennessee |
| Authorized Official Name and Position | Melissa Gail Andrews (ADMINISTRATIVE ASSISTANT) |
| Authorized Official Contact | 4232822441 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Boones Creek Dentistry 4328 N Roan St Johnson City TN 37615-4641 Ph: (423) 282-2441 | Boones Creek Dentistry 4328 N Roan St Johnson City TN 37615-4641 Ph: (423) 282-2441 |
| NPI Number | 1124726724 |
|---|---|
| Provider Enumeration Date | 02/22/2023 |
| Last Update Date | 02/22/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124726724 | NPI | - | NPPES |
| 1255828356 | Other | TN | DENTAL |
| 1326185471 | Other | TN | DENTAL |
| 1568812691 | Other | TN | DENTAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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