Organization
CDA - FORT SANDERS WEST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GARY MICHAEL PRINCE JR. (INSURANCE COORDINATOR)
(865) 539-6030
Entity
Organization
Contact information
Practice address
280 FORT SANDERS WEST BLVD STE 117, KNOXVILLE, TN 37922-3352
(865) 539-6030
(865) 539-6768
Mailing address
280 FORT SANDERS WEST BLVD STE 117, KNOXVILLE, TN 37922-3352
(865) 539-6030
(865) 539-6768
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
11/13/2023
Last updated
11/13/2023
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