Organization
DENTAL IMAGES PC
Active
Other names
Living Tree Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
ROB JOHNSON (ADMIN)
(865) 531-1715
Entity
Organization
Contact information
Practice address
1715 DOWNTOWN WEST BLVD, KNOXVILLE, TN 37919-5413
(865) 531-1715
(865) 674-5498
Mailing address
1715 DOWNTOWN WEST BLVD, KNOXVILLE, TN 37919-5413
(865) 531-1715
(865) 674-5498
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1013447382
DENTAL
—
01
—
1588789549
DENTAL
—
Enumeration date
07/26/2021
Last updated
07/26/2021
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