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General NPI Number Information
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NPI Number | 1154614162
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Entity Type | Organization
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Legal Business Name | DR. G. ANDREW AGETT, DDS, PC
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Dates
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Enumeration Date | 05/24/2011
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Last Update Date | 05/24/2011
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Provider Practice Location Address
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Address Line | 193 FRANKLIN DR
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City | BLOUNTVILLE
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State | TN
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Zip | 37617-4542
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Country | US
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Telephone | 423-323-3321
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Fax | 423-323-3271
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Provider Business Mailing Address
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Address Line | 193 FRANKLIN DR P.O. BOX 548
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City | BLOUNTVILLE
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State | TN
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Zip | 37617-4542
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Country | US
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Telephone | 423-323-3321
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Fax | 423-323-3271
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Authorized Official
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Title or Position | OWNER
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Name | DR. GEORGE ANDREW AGETT
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Credential | DDS
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Telephone | 423-323-3321
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 1798
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License Number State | TN
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