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Organization
EUGENE STINSON DDS
Active
Organization
EUGENE STINSON DDS
Active
Other names
Kodak Dental Care, PLLC
Organization subpart
No
Provider details
NPI number
Authorized official
KAY HARRISON (OFFICE MANAGER)
(865) 465-7058
Entity
Organization
Contact information
Practice address
2946 WINFIELD DUNN PKWY, SUITE 301, KODAK, TN 37764-4306
(865) 465-7058
(865) 465-3432
Mailing address
2946 WINFIELD DUNN PKWY, SUITE 301, KODAK, TN 37764-4306
(865) 465-7058
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
DS0000003957
TN
1223G0001X
General Practice Dentistry
Primary
DS0000005043
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3225522
—
TN
01
—
5440268
TENNCARE
TN
Enumeration date
10/30/2015
Last updated
10/30/2015
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