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Organization
MARYVILLE DENTAL CARE
Active
Organization
MARYVILLE DENTAL CARE
Active
Other names
Maryville Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LAURA BULL (OFFICE)
(865) 483-7851
Entity
Organization
Contact information
Practice address
1401 MONTVALE STATION RD, MARYVILLE, TN 37803-5815
(865) 984-3800
Mailing address
400 LABORATORY RD STE 101, OAK RIDGE, TN 37830-6808
(865) 483-7851
(865) 483-6391
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
NULL
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1881190619
NPI
TN
Enumeration date
09/28/2022
Last updated
09/28/2022
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