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General NPI Number Information
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NPI Number | 1578286282
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Entity Type | Organization
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Legal Business Name | NEW LIFE DENTISTRY, PLLC
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Dates
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Enumeration Date | 09/19/2022
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Last Update Date | 09/19/2022
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Provider Practice Location Address
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Address Line | 614 MABRY HOOD RD STE 201
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City | KNOXVILLE
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State | TN
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Zip | 37932-2669
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Country | US
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Telephone | 865-375-5867
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Fax |
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Provider Business Mailing Address
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Address Line | 200 N A ST
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City | LENOIR CITY
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State | TN
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Zip | 37771-2401
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Country | US
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Telephone | 865-617-6001
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. CHRISTOPHER DAVID LEE
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Credential | DMD
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Telephone | 865-617-6001
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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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