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General NPI Number Information
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NPI Number | 1386981041
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Entity Type | Organization
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Legal Business Name | ROANE DENTAL ASSOCIATES, P.C.
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Dates
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Enumeration Date | 01/14/2013
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Last Update Date | 01/14/2013
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Provider Practice Location Address
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Address Line | 1855 TANNER WAY SUITE 210
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City | HARRIMAN
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State | TN
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Zip | 37748-8302
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Country | US
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Telephone | 865-717-7743
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Fax | 865-717-6615
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Provider Business Mailing Address
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Address Line | 1855 TANNER WAY SUITE 210
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City | HARRIMAN
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State | TN
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Zip | 37748-8302
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Country | US
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Telephone | 865-717-7743
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Fax | 865-717-6615
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | DR. RAYMOND SCOTT HOLMES
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Credential | DDS
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Telephone | 865-717-7743
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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 | DS0000009313
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License Number State | TN
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