| Dandridge Pediatric Dentistry | |
|
117 E Price Rd Dandridge TN 37725-4513 | |
| (865) 940-1280 | |
| Not Available |
| Full Name | Dandridge Pediatric Dentistry |
|---|---|
| Speciality | Dentist |
| Location | 117 E Price Rd, Dandridge, Tennessee |
| Authorized Official Name and Position | Victoria P Childers (PEDIATRIC DENTIST/CO-OWNER) |
| Authorized Official Contact | 8659401280 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dandridge Pediatric Dentistry 117 E Price Rd Dandridge TN 37725-4513 Ph: (865) 940-1280 | Dandridge Pediatric Dentistry 117 E Price Rd Dandridge TN 37725-4513 Ph: (865) 940-1280 |
| NPI Number | 1144844879 |
|---|---|
| Provider Enumeration Date | 05/28/2020 |
| Last Update Date | 05/28/2020 |
| Medicare PECOS PAC ID | 8729401864 |
|---|---|
| Medicare Enrollment ID | O20200708003210 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144844879 | NPI | - | NPPES |
| Q055235 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
| Provider Name | Victoria Paige Childers |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1932550498 PECOS PAC ID: 3274956313 Enrollment ID: I20200713002049 |
Elite Dental Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 334 Highway 92 South, Suite 1, Dandridge, TN 37725 Phone: 865-397-5422 Fax: 865-397-5432 |