North River Perio PLLC

Organization Active NPI Periodontics · Hixson, TN

NPI 1477049542 · NPPES record last updated Jul 2, 2018

Key facts

NPI
1477049542
Entity type
Organization (NPI type 2)
Primary specialty
Periodontics 1223P0300X
License
7108 (TN)
Legal business name
NORTH RIVER PERIO PLLC
Practice address
5022 Old Godsey LN Ste 1
Hixson, TN 37343-6604
Phone
(423) 870-9567
Fax
(423) 870-5331
NPI assigned
Jul 2, 2018
Organization subpart
No

Authorized official

Name
Rhonda M West
Title
Insurance Manager
Phone
(423) 870-9567

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Locations

5022 Old Godsey Ln
Ste 1
Hixson, TN 37343
Phone (423) 870-9567

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics
Group: 193400000X SINGLE SPECIALTY GROUP
1223P0300X 7108 TN Yes

Addresses

Primary practice location

5022 Old Godsey LN Ste 1
Hixson, TN 37343-6604

Mailing address

5022 Old Godsey LN Ste 1
Hixson, TN 37343-6604
Phone (423) 870-9567

Other identifiers

IdentifierTypeStateIssuer
1720292907OtherTNCHARLES L MCBRAYER DDS

Other providers in Hixson, TN

All providers in Hixson, TN · Periodontics in Tennessee

Sources for this page

Verify at the official NPI Registry.