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Individual

JACLYN TALIA NUTTING

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.D.S.

Contact information

Practice address
6025 BROOKVALE LN, SUITE 110, KNOXVILLE, TN 37919-4031
(865) 588-5761
Mailing address
6025 BROOKVALE LN, SUITE 110, KNOXVILLE, TN 37919-4031
(865) 300-3149

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
9028
TN

Other

Enumeration date
06/19/2009
Last updated
12/19/2012
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