Individual
CASEY TERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
162 SHARP AND PERKINS RD, JACKSBORO, TN 37757-2507
(423) 562-8351
(423) 562-1593
Mailing address
162 SHARP AND PERKINS RD, P.O. BOX 418, JACKSBORO, TN 37757-2507
(423) 562-8351
(423) 562-1593
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
DA0000010658
TN
Other
Enumeration date
09/21/2009
Last updated
09/21/2009
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