Individual
KEVIN HATHORNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D
Contact information
Practice address
4619 SUNFLOWER RD APT 93, KNOXVILLE, TN 37909-1457
(734) 649-7231
Mailing address
4619 SUNFLOWER RD APT 93, KNOXVILLE, TN 37909-1457
(734) 649-7231
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
11969
TN
390200000X
Student in an Organized Health Care Education/Training Program
12876
CT
Other
Enumeration date
02/18/2020
Last updated
09/19/2022
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