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General NPI Number Information
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NPI Number | 1184345993
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Entity Type | Organization
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Legal Business Name | TRUE DENTAL OF HIXSON
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Dates
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Enumeration Date | 09/09/2022
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Last Update Date | 09/09/2022
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Provider Practice Location Address
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Address Line | 4513 HIXSON PIKE STE 103
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City | HIXSON
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State | TN
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Zip | 37343-5039
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Country | US
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Telephone | 423-875-6778
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Fax | 423-875-6779
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Provider Business Mailing Address
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Address Line | 4513 HIXSON PIKE STE 103
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City | HIXSON
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State | TN
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Zip | 37343-5039
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Country | US
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Telephone | 423-875-6778
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Fax | 423-875-6779
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Authorized Official
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Title or Position | OWNER
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Name | JOEL A DAVIS
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Credential | DDS
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Telephone | 423-899-9755
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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