Individual
DR. KELSEY GARDNER LAPORTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS, MD
Contact information
Practice address
205 SOUTHDOWNE DR, MARYVILLE, TN 37801-3747
(865) 381-8867
(865) 724-1803
Mailing address
205 SOUTHDOWNE DR, MARYVILLE, TN 37801-3747
(865) 381-8867
(865) 724-1803
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
11255
TN
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
7105
NE
Other
Enumeration date
06/26/2013
Last updated
07/16/2020
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