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Organization
SMOKY MOUNTAIN PEDIATRIC DENTISTRY, PLLC
Active
Organization
SMOKY MOUNTAIN PEDIATRIC DENTISTRY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHERINE BODFORD MALONE DDS (PEDIATRIC DENTIST)
(865) 766-4884
Entity
Organization
Contact information
Practice address
550 TOWN CREEK RD E, SUITE 101, LENOIR CITY, TN 37772-6289
(865) 766-4884
Mailing address
550 TOWN CREEK RD E, SUITE 101, LENOIR CITY, TN 37772-6289
(865) 766-4884
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
9031
TN
Other
Enumeration date
01/29/2014
Last updated
06/07/2014
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