Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 7394 | TN |
NPI | 1043259906 |
---|---|
Provider Name | Daniel S Read |
First Address | Knoxville, TN 37922-3304 |
Second Address | Knoxville, TN 37922-3304 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2006 |
Last Update Date | 10/08/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U42131 | (02) | TN |