Healthcare Provider Details

I. General information

NPI: 1841348547
Provider Name (Legal Business Name): DARRELL EUGENE CATES JR. DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1546 GATEWAY AVE.
ROCKWOOD TN
37854-0003
US

IV. Provider business mailing address

PO BOX 3
ROCKWOOD TN
37854-0003
US

V. Phone/Fax

Practice location:
  • Phone: 865-354-2740
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberD54296
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: