Individual
KEVIN MELANIO CORVACHO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2854 N MAIN ST STE 102, CROSSVILLE, TN 38555-5413
(931) 456-1138
Mailing address
2854 N MAIN ST STE 102, CROSSVILLE, TN 38555-5413
(931) 456-1138
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
11375
TN
Other
Enumeration date
08/28/2020
Last updated
08/28/2020
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