Organization
CORNERSTONE DENTAL ASSOCIATES EXECUTIVE PARK PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REBECCA M TUCKER (OPERATIONS MANAGER)
(865) 531-7117
Entity
Organization
Contact information
Practice address
8925 EXECUTIVE PARK DR, KNOXVILLE, TN 37923-4708
(865) 693-8871
Mailing address
8912 TOWN AND COUNTRY CIR, KNOXVILLE, TN 37923-4900
(865) 531-7117
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1205969524
NPI
TN
Enumeration date
12/30/2021
Last updated
12/30/2021
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