COLONIAL HEIGHTS DENTAL ASSOCAITES NPI 1467567412

NPI Information

COLONIAL HEIGHTS DENTAL ASSOCAITES is a general practice dentist in Kingsport, TN. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. COLONIAL HEIGHTS DENTAL ASSOCAITES NPI is 1467567412. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

150 CLINIC DRIVE
SUITE A
KINGSPORT, TN
ZIP 37663
Phone: (423) 239-8021
Fax: (423) 239-6273

The provider's authorized official is Bartley Lynn Ford .
The authorized official title is Dentist/president and has the following contact phone number (423) 239-8021.

The CLIA number assigned to this NPI record is 44D2144718 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/20/2006 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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