Organization
ROCKY TOP PEDIATRIC DENTISTRY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEAYNNE SELLERS (OFFICE MANAGER)
(865) 691-1404
Entity
Organization
Contact information
Practice address
10261 KINGSTON PIKE, KNOXVILLE, TN 37922-3276
(865) 691-1404
(865) 691-0836
Mailing address
10261 KINGSTON PIKE, KNOXVILLE, TN 37922-3276
(865) 691-1404
(865) 691-0836
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
9858
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q006211
—
TN
Enumeration date
12/23/2015
Last updated
12/23/2015
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