Provider First Line Business Practice Location Address:
2306 KNOB CREEK ROAD #108
Provider Second Line Business Practice Location Address:
KNOB CREEK ORAL CLINIC
Provider Business Practice Location Address City Name:
JOHNSON CITY
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37604
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
423-467-5009
Provider Business Practice Location Address Fax Number:
423-467-5009
Provider Enumeration Date:
02/23/2006