| Tara Ericson | |
|
6311 Kingston Pike Ste 27w Knoxville TN 37919-4900 | |
| (865) 588-7862 | |
| (865) 558-6849 |
| Full Name | Tara Ericson |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 6311 Kingston Pike Ste 27w, Knoxville, Tennessee |
| Authorized Official Name and Position | Tammie Moyers (INSURANCE COORDINATOR) |
| Authorized Official Contact | 8655887862 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tara Ericson 6311 Kingston Pike Ste 27w Knoxville TN 37919-4900 Ph: (865) 588-7862 | Tara Ericson 6311 Kingston Pike Ste 27w Knoxville TN 37919-4900 Ph: (865) 588-7862 |
| NPI Number | 1780159368 |
|---|---|
| Provider Enumeration Date | 10/10/2018 |
| Last Update Date | 10/10/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780159368 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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