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General NPI Number Information
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NPI Number | 1699750216
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Entity Type | Organization
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Legal Business Name | G STEPHEN OLLARD DDS, PLLC
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Dates
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Enumeration Date | 12/07/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 485 FORKS OF THE RIVER PKWY
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City | SEVIERVILLE
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State | TN
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Zip | 37862-3422
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Country | US
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Telephone | 865-453-6959
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Fax | 865-453-6953
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Provider Business Mailing Address
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Address Line | 485 FORKS OF THE RIVER PKWY
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City | SEVIERVILLE
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State | TN
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Zip | 37862-3422
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Country | US
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Telephone | 865-453-6959
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Fax | 865-453-6953
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Authorized Official
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Title or Position | OWNER
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Name | DR. G STEPHEN OLLARD
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Credential |
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Telephone | 865-453-6959
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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 | DS0000002088
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License Number State | TN
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