=====================================================
General NPI Number Information
=====================================================
NPI Number | 1063307494
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | BRITTNEE LYNN BOZEMAN DMD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/09/2025
-----------------------------------------------------
Last Update Date | 06/27/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7418 NORRIS FWY
-----------------------------------------------------
City | KNOXVILLE
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37938-4219
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 865-377-8560
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 305 CARDINAL DR
-----------------------------------------------------
City | WHITE HOUSE
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37188-9184
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 615-478-7578
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 122300000X
-----------------------------------------------------
Taxonomy Name | Dentist
-----------------------------------------------------
License Number | 12788
-----------------------------------------------------
License Number State | TN
-----------------------------------------------------