Individual
MR. JON ATHERTON MATHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1203 WILCOX DR, KINGSPORT, TN 37664
(423) 247-0019
(423) 247-0019
Mailing address
PO BOX 3588, 1203 WILCOX DR, KINGSPORT, TN 37664
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3577
TN
Other
Enumeration date
09/06/2006
Last updated
07/08/2007
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