| East Tennessee Pediatric Dentistry Pllc | |
|
1103 Callahan Dr Knoxville TN 37912-1310 | |
| (865) 859-0355 | |
| (865) 859-0227 |
| Full Name | East Tennessee Pediatric Dentistry Pllc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 1103 Callahan Dr, Knoxville, Tennessee |
| Authorized Official Name and Position | Jessica Phillips (OWNER) |
| Authorized Official Contact | 8658590355 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| East Tennessee Pediatric Dentistry Pllc 1103 Callahan Dr Knoxville TN 37912-1310 Ph: (865) 859-0355 | East Tennessee Pediatric Dentistry Pllc 1103 Callahan Dr Knoxville TN 37912-1310 Ph: (865) 859-0355 |
| NPI Number | 1609211267 |
|---|---|
| Provider Enumeration Date | 05/08/2013 |
| Last Update Date | 01/09/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609211267 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 9446 (Tennessee) | Primary |
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