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Individual

DR. JOHN PICKARD PRIMM

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
4527 HWY 70 EAST, WHITE BLUFF, TN 37187
(615) 797-2298
(615) 797-9958
Mailing address
PO BOX 176, WHITE BLUFF, TN 37187-0176
(615) 797-2298
(615) 797-9958

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS0000002902
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0004216
BLUE CROSS BLUE SHIELD
TN
Enumeration date
04/17/2006
Last updated
07/08/2007
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