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General NPI Number Information
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NPI Number | 1194249698
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Entity Type | Organization
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Legal Business Name | PABLO A. FONCEA, DMD, PC
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Dates
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Enumeration Date | 07/27/2017
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Last Update Date | 09/08/2020
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Provider Practice Location Address
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Address Line | 2719 KINGSTON PIKE
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City | KNOXVILLE
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State | TN
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Zip | 37919-4620
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Country | US
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Telephone | 865-973-9899
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Fax | 865-524-0194
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Provider Business Mailing Address
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Address Line | 2719 KINGSTON PIKE
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City | KNOXVILLE
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State | TN
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Zip | 37919-4620
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Country | US
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Telephone | 865-973-9899
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Fax | 865-524-0194
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Authorized Official
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Title or Position | DENTIST
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Name | DR. PABLO A FONCEA
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Credential |
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Telephone | 865-973-9899
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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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