Woodard Duffey Foutch, D.D.S.

Individual provider Active NPI General Practice Dentistry · Rutledge, TN

NPI 1831286640 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1831286640
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
DS2631 (TN)
Practice address
7786 Rutledge Pike
Rutledge, TN 37861
Phone
(865) 828-5281
Fax
(865) 828-4733
NPI assigned
Oct 5, 2006
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
DS2631TNMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DS2631 TN Yes

Addresses

Primary practice location

7786 Rutledge Pike
Rutledge, TN 37861

Mailing address

PO Box 22
Rutledge, TN 37861-0022
Phone (865) 828-5281

Other providers in Rutledge, TN

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

Sources for this page

Verify at the official NPI Registry.