Individual
DR. STEPHANIE TILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
150 CLINIC DR STE 1, KINGSPORT, TN 37663-2254
(423) 722-8833
Mailing address
150 CLINIC DR STE 1, KINGSPORT, TN 37663-2254
(423) 722-8833
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
0401416685
VA
1223P0300X
Periodontics
Primary
12143
TN
Other
Enumeration date
11/25/2020
Last updated
08/13/2025
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