| Kingston Dental Llc | |
|
1212 N Kentucky St Kingston TN 37763-2328 | |
| (865) 717-3586 | |
| (865) 717-3581 |
| Full Name | Kingston Dental Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1212 N Kentucky St, Kingston, Tennessee |
| Authorized Official Name and Position | Evon Elizabeth Hulse (BOARD MEMBER) |
| Authorized Official Contact | 8656405283 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kingston Dental Llc 1203 Old N Kentucky St Kingston TN 37763-2358 Ph: (865) 717-3586 | Kingston Dental Llc 1212 N Kentucky St Kingston TN 37763-2328 Ph: (865) 717-3586 |
| NPI Number | 1083860498 |
|---|---|
| Provider Enumeration Date | 08/18/2008 |
| Last Update Date | 10/02/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083860498 | NPI | - | NPPES |
| 1515194 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 8110 (Tennessee) | Primary |
Mobile Unit 24 Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 820 N Kentucky St, Kingston, TN 37763 Phone: 865-804-2531 Fax: 865-966-1229 | |
Lakeview Dental Arts Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1011 Waterford Pl, Kingston, TN 37763 Phone: 865-376-9687 | |
Mobile 33 Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 820 N Kentucky St, Kingston, TN 37763 Phone: 865-804-2465 Fax: 865-966-1229 | |
Mobile 4 Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 820 N Kentucky St, Kingston, TN 37763 Phone: 865-804-2531 Fax: 865-966-1229 | |
Mobile 39 Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 820 N Kentucky St, Kingston, TN 37763 Phone: 865-804-2465 Fax: 865-966-1229 | |
Mobile Unit 22 Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 820 N Kentucky St, Kingston, TN 37763 Phone: 865-804-2465 Fax: 865-966-1229 |