Organization
FOOTHILLS ENDODONTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SERENA M LOVEDAY O.M. (OFFICE MANAGER)
(865) 982-8000
Entity
Organization
Contact information
Practice address
312 HIGH ST, MARYVILLE, TN 37804-5833
(865) 982-8000
(865) 982-8512
Mailing address
312 HIGH STREET, MARYVILLE, TN 37804
(865) 982-8000
(865) 982-8512
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
5322
TN
Other
Enumeration date
02/17/2016
Last updated
02/17/2016
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