Individual
RILEY HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
303 S CONCORD ST # 323, KNOXVILLE, TN 37919-3304
(865) 637-5708
Mailing address
223 LENIZ DR, MARYVILLE, TN 37803-6113
(208) 810-0419
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12491
TN
Other
Enumeration date
05/27/2024
Last updated
05/27/2024
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