Organization
BRISTOL DENTAL GROUP, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASON PITTMAN (PRESIDENT)
(423) 989-3000
Entity
Organization
Contact information
Practice address
332 6TH ST, BRISTOL, TN 37620-2201
(423) 989-3000
Mailing address
332 6TH ST, BRISTOL, TN 37620-2201
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS8239
TN
Other
Enumeration date
07/06/2011
Last updated
07/06/2011
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