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General NPI Number Information
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NPI Number | 1659996320
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Entity Type | Organization
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Legal Business Name | PICKERING & ALLEN ORTHODONTICS
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Dates
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Enumeration Date | 06/09/2020
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Last Update Date | 06/09/2020
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Provider Practice Location Address
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Address Line | 4741 N BROADWAY ST
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City | KNOXVILLE
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State | TN
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Zip | 37918-1793
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Country | US
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Telephone | 865-687-9412
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Fax | 865-688-0656
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Provider Business Mailing Address
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Address Line | 4741 N BROADWAY ST STE C
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City | KNOXVILLE
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State | TN
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Zip | 37918-1793
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Country | US
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Telephone | 865-687-9412
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Fax | 865-688-0656
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Authorized Official
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Title or Position | OFFICE COORDINATOR
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Name | TERRI A. HANCOCK
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Credential |
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Telephone | 865-687-9412
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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