Individual
KEVIN D. GROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
603 HIGHWAY 321 N UNIT 20 BLDG 4, LENOIR CITY PROF. PARK, LENOIR CITY, TN 37771-6575
(865) 986-4582
(865) 988-8398
Mailing address
603 HIGHWAY 321 N UNIT 20 BLDG 4, LENOIR CITY PROF. PARK, LENOIR CITY, TN 37771-6575
(865) 986-4582
(865) 988-8398
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DS7297
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3226934
—
TN
Enumeration date
07/07/2005
Last updated
06/24/2021
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