Healthcare Provider Details

I. General information

NPI: 1619518388
Provider Name (Legal Business Name): LORIE DIANE TURNER RDH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2019
Last Update Date: 11/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4714 PAPERMILL DR
KNOXVILLE TN
37909-1972
US

IV. Provider business mailing address

4714 PAPERMILL DR
KNOXVILLE TN
37909-1972
US

V. Phone/Fax

Practice location:
  • Phone: 865-588-4472
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number2341
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: