MEDICARE: DR. SEAN TIMOTHY SINCLAIR D.D.S.

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	1223G0001X	General Practice Dentistry	DS 7765	TN

General Provider Information

NPI Number	:	1942272810
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SEAN TIMOTHY SINCLAIR D.D.S.

Provider Business Mailing Address
First Line	:	1117 E LAMAR ALEXANDER PKWY
Second Line	:
City	:	MARYVILLE
State	:	TN
Zip	:	37804-5130
Country	:	US
Telephone Number	:	865-681-3004
Fax Number	:	865-681-0495

Provider Business Practice Location Address
First Line	:	1117 E LAMAR ALEXANDER PKWY
Second Line	:
City	:	MARYVILLE
State	:	TN
Zip	:	37804-5130
Country	:	US
Telephone Number	:	865-681-3004
Fax Number	:	865-681-0495

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/06/2006
Last Update Date	:	07/08/2007

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