| Mobile Unit 22 | |
|
820 N Kentucky St Kingston TN 37763-2635 | |
| (865) 804-2465 | |
| (865) 966-1229 |
| Full Name | Mobile Unit 22 |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 820 N Kentucky St, Kingston, Tennessee |
| Authorized Official Name and Position | Evon Elizabeth Hulse (CO-OWNER) |
| Authorized Official Contact | 8658042465 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mobile Unit 22 820 N Kentucky St Kingston TN 37763-2635 Ph: (865) 804-2465 | Mobile Unit 22 820 N Kentucky St Kingston TN 37763-2635 Ph: (865) 804-2465 |
| NPI Number | 1629237565 |
|---|---|
| Provider Enumeration Date | 06/05/2008 |
| Last Update Date | 05/10/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629237565 | NPI | - | NPPES |
| 188598 | Other | TN | DORAL DENTAL OF TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 8165 (Tennessee) | Primary |
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Mobile Unit 24 Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 820 N Kentucky St, Kingston, TN 37763 Phone: 865-804-2531 Fax: 865-966-1229 | |
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Mobile 33 Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 820 N Kentucky St, Kingston, TN 37763 Phone: 865-804-2465 Fax: 865-966-1229 | |
Mobile 4 Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 820 N Kentucky St, Kingston, TN 37763 Phone: 865-804-2531 Fax: 865-966-1229 | |
Mobile 39 Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 820 N Kentucky St, Kingston, TN 37763 Phone: 865-804-2465 Fax: 865-966-1229 |