Cumberland Gap Orthodontics

LBN: Cumberland Gap Orthodontics
Cumberland Gap Orthodontics is an health care organization with primary practice located at 119 Westmoreland St , Harrogate TN 37752-8202. The organization recently has only one registered license in Dental Providers / Orthodontics and Dentofacial Orthopedics, which is considered as the primary health care specialty. Cumberland Gap Orthodontics can be contacted via phone (423) 869-5719, or through Douglass, Jesse Burton via phone (423) 869-5719.

Contact Information

Primary practice address
119 Westmoreland St Harrogate TN 37752-8202
Phone: (423) 869-5719
Fax: (423) 869-5749
Website:
Map and Directions
Authorized official contact:
Name: Douglass, Jesse Burton DMD MSD
Phone: (423) 869-5719

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Orthodontics and Dentofacial Orthopedics 1223X0400X

Profile Details

NPI number 1669459251
LBN Legal business name Cumberland Gap Orthodontics
DBA Doing business as
Authorized official Douglass, Jesse Burton DMD MSD
Entity Organization
Organization subpart 1 No
Enumeration date Dec 27th, 2005
Last updated Mar 17th, 2008 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1669459251 NPPES
Kentucky MEDICAID 60042058
Kentucky MEDICAID 013672

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