Organization
PREMIER FAMILY DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KATHRYN RAE EGAN DDS (SOLE MEMBER)
(423) 505-3750
Entity
Organization
Contact information
Practice address
1963 NORTHPOINT BLVD, SUITE 113, HIXSON, TN 37343-4631
(423) 551-3373
Mailing address
1963 NORTHPOINT BLVD, SUITE 113, HIXSON, TN 37343-4631
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
9373
TN
Other
Enumeration date
11/25/2014
Last updated
11/25/2014
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