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NPI Code Detail

MEDICARE: J BENJAMIN RIVERS DMD PC

MEDICARE: J BENJAMIN RIVERS DMD PC
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
1204E00000XOral & Maxillofacial Surgery (D.M.D.)2075TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1831173392
Entity Type Code : Organization
Provider Name (Legal Business Name) : J BENJAMIN RIVERS DMD PC
Provider Business Mailing Address
First Line : 6906 KINGSTON PIKE
Second Line : SUITE 205
City : KNOXVILLE
State : TN
Zip : 37919-5704
Country : US
Telephone Number : 865-588-3850
Fax Number : 865-588-3840
Provider Business Practice Location Address
First Line : 6906 KINGSTON PIKE
Second Line : SUITE 205
City : KNOXVILLE
State : TN
Zip : 37919-5704
Country : US
Telephone Number : 865-588-3850
Fax Number : 865-588-3840
Authorized Official
Title or Position : PRESIDENT
Name : JAMES BENJAMIN RIVERS SR.
Credential : DMD
Telephone Number : 865-588-3850
Provider Enumeration Date : 11/30/2005
Last Update Date : 02/01/2008

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Directions to “J BENJAMIN RIVERS DMD PC ” Practice Location

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