Organization
TOTAL DENTAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LYNORA JANE SINES BS, RN, MPH (MANAGER)
(423) 338-7777
Entity
Organization
Contact information
Practice address
108 LIFESTYLE WAY, BENTON, TN 37307-3914
(423) 338-7777
(423) 338-9326
Mailing address
108 LIFESTYLE WAY, BENTON, TN 37307-3914
(423) 338-7777
(423) 338-9326
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2526
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
108283
DORAL TENNCARE
TN
Enumeration date
03/18/2008
Last updated
03/18/2008
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