| Vonore Dental Practice P C | |
|
1277 Highway 411 Vonore TN 37885-2456 | |
| (423) 884-2300 | |
| (423) 884-2981 |
| Full Name | Vonore Dental Practice P C |
|---|---|
| Speciality | Dentist |
| Location | 1277 Highway 411, Vonore, Tennessee |
| Authorized Official Name and Position | Eric Peter Fugate (PRESIDENT) |
| Authorized Official Contact | 4238842300 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Vonore Dental Practice P C 1277 Highway 411 Vonore TN 37885-2456 Ph: (423) 884-2300 | Vonore Dental Practice P C 1277 Highway 411 Vonore TN 37885-2456 Ph: (423) 884-2300 |
| NPI Number | 1730287087 |
|---|---|
| Provider Enumeration Date | 09/20/2006 |
| Last Update Date | 07/22/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730287087 | NPI | - | NPPES |
| 1519925 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |