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NPI 1740386150

NPI 1740386150 : CHRISTOPHER O'ROURKE D.D.S., M.S. : KNOXVILLE, TN

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General NPI Number Information
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    NPI Number           |    1740386150
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    Entity Type          |    Individual 
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    Provider Name        |    CHRISTOPHER O'ROURKE D.D.S., M.S.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    09/15/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    11226 W POINT DR 
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    City                 |    KNOXVILLE
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    State                |    TN
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    Zip                  |    37934-2837
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    Country              |    US
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    Telephone            |    865-966-7732
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    Fax                  |    865-671-3301
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Provider Business Mailing Address
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    Address Line         |    11226 W POINT DR 
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    City                 |    KNOXVILLE
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    State                |    TN
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    Zip                  |    37934-2837
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    Country              |    US
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    Telephone            |    865-966-7732
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    Fax                  |    865-671-3301
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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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       |    DS-4214
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    License Number State |    TN
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