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General NPI Number Information
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NPI Number | 1023869047
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Entity Type | Individual
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Provider Name | CHRISTY SUE KING RDH
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Gender | Female
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Dates
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Enumeration Date | 03/28/2024
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Last Update Date | 03/28/2024
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Provider Practice Location Address
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Address Line | 2939 ESSARY DR STE 2
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City | KNOXVILLE
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State | TN
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Zip | 37918-2464
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Country | US
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Telephone | 865-672-6525
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Fax |
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Provider Business Mailing Address
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Address Line | 2074 MAYNARDVILLE HWY
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City | MAYNARDVILLE
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State | TN
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Zip | 37807-3014
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Country | US
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Telephone | 865-254-9147
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | 00005275
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License Number State | TN
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