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General NPI Number Information
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NPI Number | 1356330229
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Entity Type | Individual
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Provider Name | EVON ELIZABETH HULSE DDS
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Gender | Female
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Dates
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Enumeration Date | 10/13/2005
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Last Update Date | 03/26/2011
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Provider Practice Location Address
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Address Line | 1212 N KENTUCKY ST
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City | KINGSTON
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State | TN
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Zip | 37763-2328
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Country | US
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Telephone | 865-717-3586
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Fax | 865-717-3581
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Provider Business Mailing Address
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Address Line | 1203 OLD N KENTUCKY ST
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City | KINGSTON
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State | TN
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Zip | 37763-2358
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Country | US
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Telephone | 865-717-3586
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Fax | 865-717-3581
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DS8110
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License Number State | TN
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