| East Tennessee Periodontics, Llc | |
|
2040 Castaic Ln Knoxville TN 37932-1557 | |
| (865) 246-0460 | |
| (865) 482-0592 |
| Full Name | East Tennessee Periodontics, Llc |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 2040 Castaic Ln, Knoxville, Tennessee |
| Authorized Official Name and Position | Robert Craig Cain (OWNER) |
| Authorized Official Contact | 8652460460 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| East Tennessee Periodontics, Llc 2040 Castaic Ln Knoxville TN 37932-1557 Ph: (865) 246-0460 | East Tennessee Periodontics, Llc 2040 Castaic Ln Knoxville TN 37932-1557 Ph: (865) 246-0460 |
| NPI Number | 1215426853 |
|---|---|
| Provider Enumeration Date | 05/09/2018 |
| Last Update Date | 05/09/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215426853 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | (* (Not Available)) | Primary |
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