| Mobile 4 | |
|
820 N Kentucky St Kingston TN 37763-2635 | |
| (865) 804-2531 | |
| (865) 966-1229 |
| Full Name | Mobile 4 |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 820 N Kentucky St, Kingston, Tennessee |
| Authorized Official Name and Position | Evon Hulse (CO-OWNER) |
| Authorized Official Contact | 8658042531 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mobile 4 820 N Kentucky St Kingston TN 37763-2635 Ph: (865) 804-2531 | Mobile 4 820 N Kentucky St Kingston TN 37763-2635 Ph: (865) 804-2531 |
| NPI Number | 1558524173 |
|---|---|
| Provider Enumeration Date | 07/03/2008 |
| Last Update Date | 05/14/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558524173 | NPI | - | NPPES |
| 18362 | Other | TN | DORAL DENTAL OF TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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