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General NPI Number Information
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NPI Number | 1689993479
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Entity Type | Organization
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Legal Business Name | D. RONALD FOUST, D.D.S., P.C.
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Dates
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Enumeration Date | 05/19/2010
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Last Update Date | 05/19/2010
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Provider Practice Location Address
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Address Line | 3508 MARYVILLE PIKE STE D
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City | KNOXVILLE
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State | TN
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Zip | 37920-6195
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Country | US
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Telephone | 865-573-6666
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Fax | 865-579-4045
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Provider Business Mailing Address
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Address Line | 3508 MARYVILLE PIKE STE D
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City | KNOXVILLE
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State | TN
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Zip | 37920-6195
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Country | US
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Telephone | 865-573-6666
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Fax | 865-579-4045
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Authorized Official
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Title or Position | OWNER
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Name | DR. DANA RONALD FOUST
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Credential | D.D.S.
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Telephone | 865-573-6666
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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 | DS2836
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License Number State | TN
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