| Crestview Dental Care, P.c. | |
|
1850 Crest Road Maryville TN 37804-4305 | |
| (865) 982-1700 | |
| (865) 982-1746 |
| Full Name | Crestview Dental Care, P.c. |
|---|---|
| Speciality | Dentist |
| Location | 1850 Crest Road, Maryville, Tennessee |
| Authorized Official Name and Position | Thomas Wesley Spears (DENTIST) |
| Authorized Official Contact | 8659821700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Crestview Dental Care, P.c. 1850 Crest Road Maryville TN 37804-4305 Ph: (865) 982-1700 | Crestview Dental Care, P.c. 1850 Crest Road Maryville TN 37804-4305 Ph: (865) 982-1700 |
| NPI Number | 1801116272 |
|---|---|
| Provider Enumeration Date | 06/08/2010 |
| Last Update Date | 06/08/2010 |
| Medicare PECOS PAC ID | 1052696374 |
|---|---|
| Medicare Enrollment ID | O20170328001469 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801116272 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 4735 (Tennessee) | Primary |
| 1223G0001X | Dentist - General Practice | 8734 (Louisiana) | Secondary |
| Provider Name | Tommy Spears |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1134262876 PECOS PAC ID: 6406131721 Enrollment ID: I20170328001655 |
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