Organization
ERWIN DENTAL, P.L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TRAVIS C. WILES D.D.S. (OWNER)
(423) 743-6144
Entity
Organization
Contact information
Practice address
600 N MAIN AVE, ERWIN, TN 37650-1392
(423) 743-6144
(423) 743-6884
Mailing address
600 N MAIN AVE, ERWIN, TN 37650-1392
(423) 743-6144
(423) 743-6884
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS8721
TN
Other
Enumeration date
11/18/2010
Last updated
11/18/2010
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