Individual
GARY L FIELDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1205 N WILCOX DR, KINGSPORT, TN 37660-4922
(423) 247-5127
Mailing address
1205 N WILCOX DR, KINGSPORT, TN 37660-4922
(423) 247-5127
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DS2872
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9178637
—
VA
05
—
Q007318
—
TN
Enumeration date
03/24/2006
Last updated
05/18/2015
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