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Organization

GOOD LIFE HEALTHCARE SOLUTIONS, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. DEBRA MARIE HALL - FISHER RDH, RDA (PRESIDENT/ CEO)
(865) 333-1611
Entity
Organization

Contact information

Practice address
9329 MIDDLEBROOK PIKE, KNOXVILLE, TN 37931-4704
(865) 333-1611
Mailing address
PO BOX 30608, KNOXVILLE, TN 37930-0608
(865) 333-1611
(800) 879-9969

Taxonomy

Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
DS0000004867
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1003961780
CHARLES DANIEL FISHER, DDS
TN
01
1417052903
DAVID B. LEE, DDS
TN
01
1578665923
RONALD W. SMITH, DDS
TN
Enumeration date
07/12/2017
Last updated
06/16/2018
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