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Organization
TENNESSEE RIVER DENTAL, PLLC
Active
Organization
TENNESSEE RIVER DENTAL, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARCUS KENNETH RANDALL (OWNER)
(423) 877-3848
Entity
Organization
Contact information
Practice address
2835 NORTHPOINT BLVD STE 105, HIXSON, TN 37343-4862
(423) 877-3848
(423) 877-3726
Mailing address
2835 NORTHPOINT BLVD STE 105, HIXSON, TN 37343-4862
(423) 877-3848
(423) 877-3726
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
NULL
122300000X
Dentist
Primary
—
—
261QD0000X
Dental Clinic/Center
3483
TN
261QD0000X
Dental Clinic/Center
Primary
9947
TN
Other
Enumeration date
02/23/2015
Last updated
08/06/2026
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