Organization
HARVILLE ORTHODONTICS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JENNIFER NOTTINGHAM HARVILLE D.M.D. (ORTHODONTIST/OWNER)
(423) 247-5137
Entity
Organization
Contact information
Practice address
2025 MEADOWVIEW PKWY, SUITE 200, KINGSPORT, TN 37660-7386
(423) 247-5137
(423) 392-8595
Mailing address
2025 MEADOWVIEW PKWY, SUITE 200, KINGSPORT, TN 37660-7386
(423) 247-5137
(423) 392-8595
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
9754
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q002056
—
TN
Enumeration date
07/02/2015
Last updated
07/02/2015
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