Individual
DR. DAVID MICHAEL NETHERTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
304 N CHANCERY ST, MC MINNVILLE, TN 37110-2048
(931) 473-6593
(931) 473-6594
Mailing address
145 E LAUREL AVE, MC MINNVILLE, TN 37110-3656
(931) 815-3984
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS7980
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0016399
TENNCARE
TN
Enumeration date
02/27/2007
Last updated
07/08/2007
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