| Rocky Top Pediatric Dentistry, Llc | |
|
10261 Kingston Pike Knoxville TN 37922-3276 | |
| (865) 691-1404 | |
| (865) 691-0836 |
| Full Name | Rocky Top Pediatric Dentistry, Llc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 10261 Kingston Pike, Knoxville, Tennessee |
| Authorized Official Name and Position | Leaynne Sellers (OFFICE MANAGER) |
| Authorized Official Contact | 8656911404 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Rocky Top Pediatric Dentistry, Llc 10261 Kingston Pike Knoxville TN 37922-3276 Ph: (865) 691-1404 | Rocky Top Pediatric Dentistry, Llc 10261 Kingston Pike Knoxville TN 37922-3276 Ph: (865) 691-1404 |
| NPI Number | 1851756423 |
|---|---|
| Provider Enumeration Date | 12/23/2015 |
| Last Update Date | 12/23/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851756423 | NPI | - | NPPES |
| Q006211 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 9858 (Tennessee) | Primary |
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