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General NPI Number Information
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NPI Number | 1730979949
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Entity Type | Organization
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Legal Business Name | OAK RIDGE ENDODONTICS
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Dates
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Enumeration Date | 05/09/2025
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Last Update Date | 05/09/2025
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Provider Practice Location Address
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Address Line | 689 EMORY VALLEY RD STE 101
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City | OAK RIDGE
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State | TN
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Zip | 37918
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Country | US
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Telephone | 865-978-6546
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Fax |
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Provider Business Mailing Address
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Address Line | 3248 TAZEWELL PIKE STE 101
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City | KNOXVILLE
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State | TN
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Zip | 37918-2537
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Country | US
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Telephone | 865-978-6546
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | DANIEL CROSSEN
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Credential | DMD, MS
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Telephone | 865-978-6546
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number |
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License Number State |
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