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Organization
COUNTY OF SULLIVAN
Active
Organization
COUNTY OF SULLIVAN
Active
Other names
Kingsport Health Center Dental Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GARY MAYES (REGIONAL DIRECTOR)
(423) 279-2777
Entity
Organization
Contact information
Practice address
1041 E SULLIVAN ST, KINGSPORT, TN 37660-5242
(423) 224-1600
(423) 224-1640
Mailing address
PO BOX 630, BLOUNTVILLE, TN 37617-0630
(423) 279-2777
(423) 279-2797
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
NULL
Other
Enumeration date
05/13/2008
Last updated
05/13/2008
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