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General NPI Number Information
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NPI Number | 1437423217
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Entity Type | Organization
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Legal Business Name | MICHAEL E. EDENFIELD, DDS, PC
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Dates
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Enumeration Date | 02/27/2012
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Last Update Date | 02/27/2012
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Provider Practice Location Address
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Address Line | 2937 ESSARY RD.
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City | KNOXVILLE
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State | TN
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Zip | 37918
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Country | US
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Telephone | 865-686-0050
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Fax | 865-686-0053
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Provider Business Mailing Address
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Address Line | 2937 ESSARY RD.
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City | KNOXVILLE
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State | TN
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Zip | 37918
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Country | US
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Telephone | 865-686-0050
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Fax | 865-686-0053
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | MICHAEL EDWARD EDENFIELD
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Credential | D.D.S.
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Telephone | 865-686-0050
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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 | DS0000008822
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DS0000009153
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DS0000008123
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License Number State | TN
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