Organization
EAST TENNESSEE FAMILY DENTISTRY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMBER LAWSON (OFFICE MANAGER)
(865) 584-8630
Entity
Organization
Contact information
Practice address
150 E DIVISION RD STE 6, OAK RIDGE, TN 37830-6908
(865) 482-1701
(865) 482-6176
Mailing address
6311 KINGSTON PIKE STE 8W, KNOXVILLE, TN 37919-4906
(865) 584-8630
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1215017595
INDIVIDUAL NPI
TN
01
—
1518585918
NPI
TN
Enumeration date
07/28/2022
Last updated
02/05/2024
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