Organization
RICHLAND CREEK DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MCKENZIE BOLING DDS (OWNER DENTIST)
(423) 834-9900
Entity
Organization
Contact information
Practice address
1272 MARKET ST, DAYTON, TN 37321
(423) 834-9900
Mailing address
668 DAYCO DR, DAYTON, TN 37321-6733
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
10259
TN
Other
Enumeration date
09/23/2016
Last updated
09/23/2016
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