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General NPI Number Information
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NPI Number | 1679588263
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Entity Type | Organization
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Legal Business Name | HULSE DENTAL PRACTICE PC
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Dates
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Enumeration Date | 07/30/2006
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Last Update Date | 06/05/2008
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Provider Practice Location Address
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Address Line | 7424 S. NORTHSHORE DRIVE
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City | KNOXVILLE
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State | TN
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Zip | 37919
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Country | US
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Telephone | 865-804-2465
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Fax | 865-671-3067
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Provider Business Mailing Address
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Address Line | 7424 S. NORTHSHORE DRIVE
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City | KNOXVILLE
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State | TN
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Zip | 37919
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Country | US
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Telephone | 865-804-2465
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Fax | 865-671-3067
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RUSSELL ARBREY HULSE
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Credential | D.D.S.
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Telephone | 865-640-5565
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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 |
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License Number State |
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