| Etowah Dental | |
|
620 Tennessee Ave Etowah TN 37331-1304 | |
| (423) 623-7315 | |
| (423) 626-5055 |
| Full Name | Etowah Dental |
|---|---|
| Speciality | Dentist |
| Location | 620 Tennessee Ave, Etowah, Tennessee |
| Authorized Official Name and Position | Raymond L Pate (CEO) |
| Authorized Official Contact | 4233335656 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Etowah Dental 620 Tennessee Ave Etowah TN 37331-1304 Ph: (423) 623-7315 | Etowah Dental 620 Tennessee Ave Etowah TN 37331-1304 Ph: (423) 623-7315 |
| NPI Number | 1215243795 |
|---|---|
| Provider Enumeration Date | 08/23/2010 |
| Last Update Date | 08/23/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215243795 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |