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Individual

DR. REGGIE M. WADDELL

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
3629 NEAL DR, KNOXVILLE, TN 37918-5312
(865) 922-7471
(865) 925-4829
Mailing address
3629 NEAL DR, KNOXVILLE, TN 37918-5312
(865) 922-7471
(865) 925-4829

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS 3136
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0000136
FORTIS/ASSURANT
TN
01
104396
CIGNA HMO
TN
01
2000187
BCBSTN
TN
01
47674
DHA
TN
Enumeration date
05/02/2006
Last updated
07/08/2007
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