Organization
ADVANCED DENTAL CONCEPTS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FREDRICO ALBERT DIXON III DDS (PRESIDENT)
(865) 584-7336
Entity
Organization
Contact information
Practice address
6311 KINGSTON PIKE, SUITE 8-W, KNOXVILLE, TN 37919-4906
(865) 584-7336
(865) 584-6208
Mailing address
6311 KINGSTON PIKE, SUITE 8-W, KNOXVILLE, TN 37919-4906
(865) 584-7336
(865) 584-6208
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS7270
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110001
TN CARE LOCATION
TN
01
—
1508041526
HYGENIST NPI #
TN
05
—
1525931
—
TN
Enumeration date
10/27/2006
Last updated
12/13/2011
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