Individual
MS. OLIVIA NICOLE GANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
219 PRINCETON ROAD, JOHNSON CITY, TN 37601
(423) 975-2200
(423) 975-2210
Mailing address
219 PRINCETON ROAD, JOHNSON CITY, TN 37601
(423) 975-2200
(423) 975-2210
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
0401411537
VA
1223G0001X
General Practice Dentistry
Primary
DS9546
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9183867
DORAL
VA
Enumeration date
09/28/2006
Last updated
02/22/2019
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us