# DICKENSON DENTAL

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043730005
- **Authorized official:** DR. BRENT M DICKENSON DDS (DENTIST)
- **Authorized official phone:** (865) 314-3859

## Contact information

- **Practice address:** 2620 MINERAL SPRINGS AVE, KNOXVILLE, TN 37917-1569
- **Practice address phone:** (865) 688-4442
- **Mailing address:** 10323 EVENING RIDGE LN, KNOXVILLE, TN 37922-7244

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | 9681 | TN | Yes |

## Other

- **Enumeration date:** 06/21/2017
- **Last updated:** 06/21/2017