Individual
MRS. LARA M FRETWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
148 STUART CROSSING NE, CLEVELAND, TN 37312-4065
(423) 472-6482
(423) 472-6699
Mailing address
148 STUART CROSSING NE, CLEVELAND, TN 37312-4065
(423) 472-6482
(423) 472-6699
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
9179
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
025
TENNDENT
TN
05
—
025
—
TN
Enumeration date
06/30/2010
Last updated
02/13/2025
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