Etowah Dental

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

ETOWAH DENTAL

Practice address

620 Tennessee Ave
Etowah, TN 37331-1304

Phone

(423) 623-7315

Fax

(423) 626-5055

NPI assigned

Aug 23, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Raymond L Pate Jr., D.M.D.

Title

Ceo

Phone

(423) 333-5656

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1282521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282521600000",
    "number": "1215243795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 TENNESSEE AVE",
            "city": "ETOWAH",
            "state": "TN",
            "postal_code": "373311304",
            "telephone_number": "423-623-7315",
            "fax_number": "423-626-5055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 TENNESSEE AVE",
            "city": "ETOWAH",
            "state": "TN",
            "postal_code": "373311304",
            "telephone_number": "423-623-7315",
            "fax_number": "423-626-5055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ETOWAH DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-23",
        "last_updated": "2010-08-23",
        "status": "A",
        "authorized_official_last_name": "PATE",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "423-333-5656",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Doctors Hospital of McMinn County, LLC
• Doctors Hospital of McMinn County, LLC
• Doctors Hospital of McMinn County, LLC
• Bonnie Edwards
• Encompass Family Practice LLC
• Etowah Family Practice PLC
• Etowah Opco LLC
• Fast Pace Medical Clinic PLLC
• Fast Pace Medical Clinic PLLC
• William Eugene Freeman, M.ED., LPC

• Dentist in Etowah, TN
• Providers in Etowah, TN by specialty
• Dentist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.