MEDICARE: RIVER MOUNTAIN ORTHODONTICS PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry

General Provider Information

NPI Number	:	1598581357
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RIVER MOUNTAIN ORTHODONTICS PLLC

Provider Business Mailing Address
First Line	:	1724 HAMILL RD STE 202
Second Line	:
City	:	HIXSON
State	:	TN
Zip	:	37343-5098
Country	:	US
Telephone Number	:	423-870-2926
Fax Number	:

Provider Business Practice Location Address
First Line	:	1724 HAMILL RD STE 202
Second Line	:
City	:	HIXSON
State	:	TN
Zip	:	37343-5098
Country	:	US
Telephone Number	:	423-870-2926
Fax Number	:

Authorized Official
Title or Position	:	ORTHODONTIST / OWNER
Name	:	DR. RAYMOND MCLAGAN
Credential	:	DMD
Telephone Number	:	573-239-0087

Provider Enumeration Date	:	11/26/2024
Last Update Date	:	04/06/2026

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