Leonard Ray Fuqua JR. DDS, MS

NPI 1063493500 - Dentist - 1223X0400X

NPI Details
NPI 1063493500
Gender Male
Enumeration Date 11/10/2005
Last Updated 07/05/2011
Entity Type Individual
Active Over 11 years ago
Practice Location
505 N KENTUCKY ST
KINGSTON TN, 37763-2630, US
Phone (865) 376-4445
Fax (865) 376-4441
Business Location
505 N KENTUCKY ST
KINGSTON TN, 37763-2630, US
Phone (865) 376-4445
Fax (865) 376-4441
Toxanomy
Taxonomy Code 1223X0400X
License State Tennessee
License Number DS0000002917
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According to our database, Dr. Leonard Ray Fuqua JR. DDS, MS NPI is 1063493500, taxonomy code is 1223X0400X and license number is DS0000002917, license state is located at Tennessee. Leonard Ray Fuqua JR. DDS, MS physically located at 505 N Kentucky St, Kingston TN, 37763-2630. NPI Number Leonard Ray Fuqua JR. DDS, MS has the Individual type.

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1063493500 NPI number is provided on an as is basis without warranty of any kind. 1063493500 is maintained by the National Plan & Provider Enumeration System. The contents of Leonard Ray Fuqua JR. DDS, MS are for informational purposes only.