# EUGENE STINSON DDS

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Kodak Dental Care, PLLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1639541543
- **Authorized official:** KAY HARRISON (OFFICE MANAGER)
- **Authorized official phone:** (865) 465-7058

## Contact information

- **Practice address:** 2946 WINFIELD DUNN PKWY, SUITE 301, KODAK, TN 37764-4306
- **Practice address phone:** (865) 465-7058
- **Practice address fax:** (865) 465-3432
- **Mailing address:** 2946 WINFIELD DUNN PKWY, SUITE 301, KODAK, TN 37764-4306
- **Mailing address phone:** (865) 465-7058

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | DS0000003957 | TN | — |
| 1223G0001X | General Practice Dentistry | DS0000005043 | TN | Yes |

## Other

- **Enumeration date:** 10/30/2015
- **Last updated:** 10/30/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 3225522 | — | TN |
| 01 | — | 5440268 | TENNCARE | TN |