Healthcare Provider Details

I. General information

NPI: 1235239237
Provider Name (Legal Business Name): JOSEPH CLINTON HURLEY DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: J CLINT HURLEY DDS

II. Dates (important events)

Enumeration Date: 09/22/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3231 ROY MESSER HWY
WHITE PINE TN
37890
US

IV. Provider business mailing address

PO BOX 769
WHITE PINE TN
37890
US

V. Phone/Fax

Practice location:
  • Phone: 865-674-2541
  • Fax: 865-674-6484
Mailing address:
  • Phone: 865-674-2541
  • Fax: 865-674-6484

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDS005279
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: