Organization
ETOWAH DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAYMOND L PATE JR. D.M.D. (CEO)
(423) 333-5656
Entity
Organization
Contact information
Practice address
620 TENNESSEE AVE, ETOWAH, TN 37331-1304
(423) 623-7315
(423) 626-5055
Mailing address
620 TENNESSEE AVE, ETOWAH, TN 37331-1304
(423) 623-7315
(423) 626-5055
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
08/23/2010
Last updated
08/23/2010
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