Healthcare Provider Details

I. General information

NPI: 1568447902
Provider Name (Legal Business Name): DAVID NEAL TROUTMAN DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 12/08/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

430 COLLEGE ST COCKE COUNTY HEALTH DEPT
NEWPORT TN
37821-3752
US

IV. Provider business mailing address

2773 ASHTON LN
SEVIERVILLE TN
37876-7902
US

V. Phone/Fax

Practice location:
  • Phone: 423-623-8733
  • Fax:
Mailing address:
  • Phone: 865-908-5389
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDS4538
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: