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General NPI Number Information
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NPI Number | 1144802851
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Entity Type | Organization
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Legal Business Name | PIPPIN DENTAL CARE
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Dates
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Enumeration Date | 04/22/2021
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Last Update Date | 09/07/2021
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Provider Practice Location Address
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Address Line | 1106 GLENNHILL LN
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City | SEVIERVILLE
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State | TN
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Zip | 37862-6915
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Country | US
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Telephone | 865-453-6789
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Fax | 865-429-0380
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Provider Business Mailing Address
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Address Line | 1106 GLENNHILL LN
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City | SEVIERVILLE
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State | TN
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Zip | 37862-6915
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Country | US
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Telephone | 865-453-6789
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Fax | 865-429-0380
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MINDY HAZELWOOD
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Credential |
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Telephone | 865-453-6789
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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