Etowah Dental | |
620 Tennessee Ave Etowah TN 37331-1304 | |
(423) 623-7315 | |
(423) 626-5055 |
Full Name | Etowah Dental |
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Speciality | Dentist |
Location | 620 Tennessee Ave, Etowah, Tennessee |
Authorized Official Name and Position | Raymond L Pate (CEO) |
Authorized Official Contact | 4233335656 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Etowah Dental 620 Tennessee Ave Etowah TN 37331-1304 Ph: (423) 623-7315 | Etowah Dental 620 Tennessee Ave Etowah TN 37331-1304 Ph: (423) 623-7315 |
NPI Number | 1215243795 |
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Provider Enumeration Date | 08/23/2010 |
Last Update Date | 08/23/2010 |
Identifier | Type | State | Issuer |
---|---|---|---|
1215243795 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | (* (Not Available)) | Primary |