Organization
LINCOLN MEMORIAL UNIVERSITY
Active
Other names
LMU Dental Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
SABRINA LAYEL (ASSISTANT VICE PRESIDENT, FINANCE)
(423) 869-6229
Entity
Organization
Contact information
Practice address
1705 ST. MARY STREET, KNOXVILLE, TN 37917
(865) 338-5755
Mailing address
6965 CUMBERLAND GAP PKWY, HARROGATE, TN 37752-8231
(423) 869-6229
(423) 869-6229
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
—
—
1223G0001X
General Practice Dentistry
—
—
1223P0221X
Pediatric Dentistry
—
—
1223P0300X
Periodontics
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
1223X0008X
Oral and Maxillofacial Radiology Dentistry
—
—
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4166520
BLUE CROSS BLUE SHIELD OF TENNESSEE
TN
Enumeration date
11/08/2007
Last updated
04/26/2022
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