# KEVIN G HARTMAN ESTATE

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

## Provider details

- **NPI number:** 1982947974
- **Authorized official:** LISA COVINGTON (OWNER/ OFFICE MANAGER)
- **Authorized official phone:** (423) 636-1911

## Contact information

- **Practice address:** 816 TUSCULUM BLVD, SUITE 1, GREENEVILLE, TN 37745-4092
- **Practice address phone:** (423) 636-1911
- **Practice address fax:** (423) 798-9962
- **Mailing address:** 816 TUSCULUM BLVD, SUITE 1, GREENEVILLE, TN 37745-4092
- **Mailing address phone:** (423) 636-1911
- **Mailing address fax:** (423) 798-9962

## Taxonomy

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

## Other

- **Enumeration date:** 03/28/2013
- **Last updated:** 01/03/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 4344722 | BCBS | TN |