Healthcare Provider Details

I. General information

NPI: 1043259906
Provider Name (Legal Business Name): DANIEL S READ DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: DANIEL S READ DMD

II. Dates (important events)

Enumeration Date: 06/06/2006
Last Update Date: 08/10/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 FOX RD STE 201
KNOXVILLE TN
37922-3304
US

IV. Provider business mailing address

111 FOX RD STE 201
KNOXVILLE TN
37922-3304
US

V. Phone/Fax

Practice location:
  • Phone: 865-291-1520
  • Fax: 865-291-1521
Mailing address:
  • Phone: 865-291-1520
  • Fax: 865-291-1521

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number7394
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: