Organization
TUSCULUM DENTAL CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CRAIG A. SHEPHERD (OWNER)
(423) 639-7575
Entity
Organization
Contact information
Practice address
22 NORTON RD, GREENEVILLE, TN 37745-3065
(423) 639-7575
Mailing address
22 NORTON RD, GREENEVILLE, TN 37745-3065
(423) 639-7575
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4696
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0016543
DORAL
TN
01
—
0103526
BCBSTN
TN
Enumeration date
03/20/2008
Last updated
03/20/2008
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