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NPI 1831208511

NPI 1831208511 : ROBERT LEE PRYOR DDS MS : OAK RIDGE, TN

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General NPI Number Information
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    NPI Number           |    1831208511
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    Entity Type          |    Individual 
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    Provider Name        |    ROBERT LEE PRYOR DDS MS
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    08/29/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    126 EAST DIVISION ROAD 
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    City                 |    OAK RIDGE
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    State                |    TN
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    Zip                  |    37830
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    Country              |    US
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    Telephone            |    865-481-0008
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    Fax                  |    865-481-0695
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Provider Business Mailing Address
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    Address Line         |    126 EAST DIVISION ROAD 
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    City                 |    OAK RIDGE
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    State                |    TN
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    Zip                  |    37830
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    Country              |    US
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    Telephone            |    865-481-0008
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    Fax                  |    865-481-0695
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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        |    1223P0221X
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    Taxonomy Name        |    Pediatric Dentistry
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    License Number       |    DS0000004086
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    License Number State |    TN
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