Organization
NORTHEAST TN PUBLIC HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. REBECCA B VESTAL DDS (DENTAL DIRECTOR)
(423) 979-3200
Entity
Organization
Contact information
Practice address
1233 SOUTHWEST AVE EXT, JOHNSON CITY, TN 37604
(423) 979-3200
(423) 979-3267
Mailing address
1233 SOUTHWEST AVE EXT, JOHNSON CITY, TN 37604
(423) 979-3200
(423) 979-3267
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3209286
—
TN
Enumeration date
12/06/2005
Last updated
08/22/2020
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