Kingston Dental LLC

NPI #1972837524 in Kingston, Tennessee

Provider Information

NPI Number: 1972837524
Entity Type: Organization
Organization Name: Kingston Dental LLC
Subpart: Yes (part of a larger organization)
Parent Organization: KINGSTON DENTAL LLC
Primary Specialty: Dentist - General Practice
Enumeration Date: Sep 30, 2009
Last Updated: May 10, 2010

Practice Location

Address: 820 N KENTUCKY ST
City: Kingston
State: Tennessee
ZIP Code: 37763-2635
Phone: (865) 804-2465

Authorized Official

Name: DR. EVON HULSE, DDS
Title: OWNER
Phone: (865) 804-2465

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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