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General NPI Number Information
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NPI Number | 1740322262
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Entity Type | Organization
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Legal Business Name | DRS CARVER STAKIAS MATHER & SMITH PC
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Dates
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Enumeration Date | 02/12/2007
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Last Update Date | 11/17/2009
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Provider Practice Location Address
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Address Line | 1203 N WILCOX DRIVE
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City | KINGSPORT
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State | TN
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Zip | 37660
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Country | US
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Telephone | 423-247-5175
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Fax | 423-247-0019
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Provider Business Mailing Address
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Address Line | 1203 N WILCOX DRIVE
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City | KINGSPORT
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State | TN
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Zip | 37660
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Country | US
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Telephone | 423-247-5175
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Fax | 423-247-0019
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Authorized Official
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Title or Position | SECY TREAS
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Name | DR. JOSEPH K CARVER
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Credential | DDS
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Telephone | 423-247-5175
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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