| Pediatric Dentistry Pc | |
|
1516 Coleman Rd Suite 201 Knoxville TN 37909-3809 | |
| (865) 558-8857 | |
| (865) 558-0291 |
| Full Name | Pediatric Dentistry Pc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 1516 Coleman Rd, Knoxville, Tennessee |
| Authorized Official Name and Position | Michael James Koch (BUSINESS MANAGER) |
| Authorized Official Contact | 8655588857 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pediatric Dentistry Pc 1516 Coleman Rd Suite 201 Knoxville TN 37909-3809 Ph: (865) 558-8857 | Pediatric Dentistry Pc 1516 Coleman Rd Suite 201 Knoxville TN 37909-3809 Ph: (865) 558-8857 |
| NPI Number | 1437557378 |
|---|---|
| Provider Enumeration Date | 12/09/2014 |
| Last Update Date | 12/09/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437557378 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 3722 (Tennessee) | Secondary |
| 1223P0221X | Dentist - Pediatric Dentistry | 9902 (Tennessee) | Primary |
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