Individual
EVAN JAMES AGNETTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS, MS
Contact information
Practice address
6311 KINGSTON PIKE STE 26W, KNOXVILLE, TN 37919-4900
(208) 761-1210
Mailing address
1205 IVES ST, WATERTOWN, NY 13601-4216
(208) 761-1210
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
0000011286
TN
Other
Enumeration date
09/18/2020
Last updated
09/18/2020
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