| Daniel M Dietrich, Dds, Pc | |
|
1105 W Stone Dr Kingsport TN 37660-2558 | |
| (423) 246-7900 | |
| (423) 246-1503 |
| Full Name | Daniel M Dietrich, Dds, Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1105 W Stone Dr, Kingsport, Tennessee |
| Authorized Official Name and Position | Wendy Thompson (BUSINESS ASSISTANT) |
| Authorized Official Contact | 4232467900 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Daniel M Dietrich, Dds, Pc 1105 W Stone Dr Kingsport TN 37660-2558 Ph: (423) 246-7900 | Daniel M Dietrich, Dds, Pc 1105 W Stone Dr Kingsport TN 37660-2558 Ph: (423) 246-7900 |
| NPI Number | 1144765793 |
|---|---|
| Provider Enumeration Date | 01/05/2017 |
| Last Update Date | 01/05/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144765793 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 3041 (Tennessee) | Primary |
| 1223G0001X | Dentist - General Practice | 5285 (Tennessee) | Secondary |
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