Clint Ole Brodal is a Dentist in Maryville, Tennessee. Clint Ole Brodal practices all healthcare services and medical treatments related to Dentist. The NPI Number for Clint Ole Brodal is 1720235781. The last update date is 2016-07-08.
Clint Ole Brodal's current location address is 121 Parliament Dr, Maryville, Tennessee. You can contact this provider via phone number 8659778700 and fax number 8659775464. The mailing address for Clint Ole Brodal is 121 Parliament Dr, Maryville, Tennessee. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Clint Ole Brodal |
|---|---|
| Address | 121 Parliament Dr, Maryville, Tennessee |
| Phone Number | 8659778700 |
| Fax Number | 8659775464 |
| Sole Proprietor | N |
| Credentials | DMD |
NPI Number Detail
| NPI Number | 1720235781 |
|---|---|
| Provider Enumeration Date | 2008-08-21 |
| Last Updated Date | 2016-07-08 |
Provider Mailing Address Detail
| Address | 121 Parliament Dr |
|---|---|
| City | Maryville |
| State | Tennessee (TN) |
| Post Code | 378046210 |
| Phone Number | 8659778700 |
| Fax Number | 8659775464 |
Provider's Primary Taxonomy Detail
| Speciality | Dentist |
|---|---|
| Taxonomy | 122300000X |
| Licence No | D9259 |
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Definition: A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: denti |
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What is the unique identifier code issued to Clint Ole Brodal by the Centers for Medicare & Medicaid Services?
The Clint Ole Brodal has been assigned the NPI (National Provider Identifier) 1720235781. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you provide the complete physical address where Clint Ole Brodal is located?
The Clint Ole Brodal is situated at the following address: 121 Parliament Dr, Maryville, TN, 378046210.
What is the Clint Ole Brodal's specialty and taxonomy code?
The Clint Ole Brodal's specialty is Dentist, and the corresponding taxonomy code is 122300000X.
On what date did the Centers for Medicare & Medicaid Services issue the 1720235781 to Clint Ole Brodal?
The Clint Ole Brodal received its 1720235781 assignment from the Centers for Medicare & Medicaid Services on 2008-08-21.
As of what date were the Clint Ole Brodal's details last updated?
The information pertaining to the Clint Ole Brodal, including its address, specialty, and other details, was most recently updated on 2016-07-08.