Healthcare Provider Details

I. General information

NPI: 1053494609
Provider Name (Legal Business Name): EDGAR GRAYTON FRENCH JR. DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/24/2006
Last Update Date: 02/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

705 GATE LN SUITE 101
KNOXVILLE TN
37909-3518
US

IV. Provider business mailing address

705 GATE LN SUITE 101
KNOXVILLE TN
37909-3518
US

V. Phone/Fax

Practice location:
  • Phone: 865-522-5437
  • Fax: 865-588-1862
Mailing address:
  • Phone: 865-522-5437
  • Fax: 865-588-1862

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDS2060
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: