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General NPI Number Information
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NPI Number | 1174419360
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Entity Type | Individual
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Provider Name | EVELYN JEAN TERUEL DMD
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Gender | Female
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Dates
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Enumeration Date | 06/16/2025
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Last Update Date | 06/16/2025
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Provider Practice Location Address
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Address Line | 7315 CLINTON HWY
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City | POWELL
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State | TN
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Zip | 37849-5225
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Country | US
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Telephone | 865-509-8782
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Fax |
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Provider Business Mailing Address
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Address Line | 1534 GREENBRIER RIDGE WAY APT 1507
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City | KNOXVILLE
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State | TN
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Zip | 37909-3397
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Country | US
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Telephone | 864-354-1311
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 12804
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License Number State | TN
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