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Organization

PIKEVILLE FAMILY DENTISTRY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
FREDERICK LEE DDS (DENTIST)
(423) 488-0623
Entity
Organization

Contact information

Practice address
3086 MAIN ST, PIKEVILLE, TN 37367
(423) 447-2421
Mailing address
PO BOX 489, PIKEVILLE, TN 37367-0489

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
9096
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1521399
TN
Enumeration date
04/25/2012
Last updated
04/25/2012
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