Provider Demographics
NPI:1043027477
Name:BIRDWELL AND GUFFEY FAMILY DENTISTRY, PLLC
Entity type:Organization
Organization Name:BIRDWELL AND GUFFEY FAMILY DENTISTRY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSURANCE COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:E
Authorized Official - Last Name:BLAYLOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-573-9629
Mailing Address - Street 1:529 GOVERNOR JOHN SEVIER HWY
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37920-6753
Mailing Address - Country:US
Mailing Address - Phone:865-573-9629
Mailing Address - Fax:865-577-3966
Practice Address - Street 1:529 GOVERNOR JOHN SEVIER HWY
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-6753
Practice Address - Country:US
Practice Address - Phone:865-573-9629
Practice Address - Fax:865-577-3966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-18
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty