Advanced Dental Concepts PC

Organization Active NPI General Practice Dentistry · Knoxville, TN

NPI 1417033804 · NPPES record last updated Dec 13, 2011

Key facts

NPI
1417033804
Entity type
Organization (NPI type 2)
Primary specialty
General Practice Dentistry 1223G0001X
License
DS7270 (TN)
Legal business name
ADVANCED DENTAL CONCEPTS PC
Practice address
6311 Kingston Pike
Suite 8-W
Knoxville, TN 37919-4906
Phone
(865) 584-7336
Fax
(865) 584-6208
NPI assigned
Oct 27, 2006
Organization subpart
No

Authorized official

Name
Dr. Fredrico Albert Dixon III, DDS
Title
President
Phone
(865) 584-7336

National Provider Directory

Locations

6311 Kingston Pike
Ste 8W
Knoxville, TN 37919
Phone (865) 306-5995

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry
Group: 193400000X SINGLE SPECIALTY GROUP
1223G0001X DS7270 TN Yes

Addresses

Primary practice location

6311 Kingston Pike
Suite 8-W
Knoxville, TN 37919-4906

Mailing address

6311 Kingston Pike
Suite 8-W
Knoxville, TN 37919-4906
Phone (865) 584-7336

Other identifiers

IdentifierTypeStateIssuer
1525931MedicaidTN
110001OtherTNTN CARE LOCATION
1508041526OtherTNHYGENIST NPI #

Other providers in Knoxville, TN

All providers in Knoxville, TN · General Practice Dentistry in Tennessee

Sources for this page

Verify at the official NPI Registry.