Healthcare Provider Details

I. General information

NPI: 1598581357
Provider Name (Legal Business Name): RIVER MOUNTAIN ORTHODONTICS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/26/2024
Last Update Date: 04/06/2026
Certification Date: 04/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1724 HAMILL RD STE 202
HIXSON TN
37343-5098
US

IV. Provider business mailing address

1724 HAMILL RD STE 202
HIXSON TN
37343-5098
US

V. Phone/Fax

Practice location:
  • Phone: 423-870-2926
  • Fax:
Mailing address:
  • Phone: 423-870-2926
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. RAYMOND MCLAGAN
Title or Position: ORTHODONTIST / OWNER
Credential: DMD
Phone: 573-239-0087