| Knoxville Pediatric Dentistry | |
|
95 Seaboard Ln Ste 102 Brentwood TN 37027-3037 | |
| (504) 638-0303 | |
| Not Available |
| Full Name | Knoxville Pediatric Dentistry |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 95 Seaboard Ln Ste 102, Brentwood, Tennessee |
| Authorized Official Name and Position | Charlotte Dasch (DIRECTOR OF OPERATIONS) |
| Authorized Official Contact | 5046380303 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Knoxville Pediatric Dentistry 1610 54th Ave N Ste 205 Nashville TN 37209-1442 Ph: (504) 638-0303 | Knoxville Pediatric Dentistry 95 Seaboard Ln Ste 102 Brentwood TN 37027-3037 Ph: (504) 638-0303 |
| NPI Number | 1639720295 |
|---|---|
| Provider Enumeration Date | 09/25/2019 |
| Last Update Date | 10/18/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639720295 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | (* (Not Available)) | Secondary |
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