Individual
DR. MATTHEW BLAKE KICKLITER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
1950 W MORRIS BLVD, MORRISTOWN, TN 37814-3764
(423) 586-8144
Mailing address
1950 W MORRIS BLVD, MORRISTOWN, TN 37814-3764
(423) 586-8144
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
9493
TN
Other
Enumeration date
07/18/2012
Last updated
07/18/2012
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