Healthcare Provider Details

I. General information

NPI: 1457507212
Provider Name (Legal Business Name): GEORGE JOSHUA STEEDLEY DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2008
Last Update Date: 04/24/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 W OLDHAM AVE
KNOXVILLE TN
37921-2747
US

IV. Provider business mailing address

801 W OLDHAM AVE
KNOXVILLE TN
37921-2747
US

V. Phone/Fax

Practice location:
  • Phone: 865-522-1244
  • Fax: 865-525-7041
Mailing address:
  • Phone: 865-522-1244
  • Fax: 865-525-7041

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number8874
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: