# FAMILY DENTAL CENTER TRICITIES, PC

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

## Provider details

- **NPI number:** 1588326144
- **Authorized official:** DR. TATUM L KINDER DDS (DENTIST)
- **Authorized official phone:** (423) 247-6961

## Contact information

- **Practice address:** 116 JACK WHITE DR STE 12, KINGSPORT, TN 37664-2379
- **Practice address phone:** (423) 247-6961
- **Practice address fax:** (423) 247-5552
- **Mailing address:** 116 JACK WHITE DR STE 12, KINGSPORT, TN 37664-2379
- **Mailing address phone:** (423) 247-6961
- **Mailing address fax:** (423) 247-5552

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 10/12/2021
- **Last updated:** 10/12/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 8105 | INSURANCE COMPANIES | TN |