Organization
MARYVILLE DENTAL, PLLC.
Active
Other names
Maryville Dental
Organization subpart
No
Provider details
NPI number
Authorized official
AMY HUGHES (OFFICE MANAGER)
(865) 440-1526
Entity
Organization
Contact information
Practice address
1765 W BROADWAY AVE, MARYVILLE, TN 37801-5509
(865) 440-1526
Mailing address
7456 RAVENCREST LN, CORRYTON, TN 37721-3735
(865) 440-1526
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
10/04/2022
Last updated
10/04/2022
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