Organization
COUNTRY CREEK DENTAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NATHAN LA MONICA DMD (DENTIST)
(775) 291-0075
Entity
Organization
Contact information
Practice address
207 KINGS CT, ALCOA, TN 37701-1939
(865) 983-6361
Mailing address
7605 GILMORE LN, CORRYTON, TN 37721-4128
(775) 291-0075
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
10031
TN
Other
Enumeration date
10/16/2017
Last updated
10/16/2017
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