Provider Demographics
NPI:1144634114
Name:MUSCARI, JAMES
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:MUSCARI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:824 W. LAMAR ALEXANDER PKWY
Mailing Address - Street 2:
Mailing Address - City:MARYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37801
Mailing Address - Country:US
Mailing Address - Phone:865-379-7004
Mailing Address - Fax:865-719-7004
Practice Address - Street 1:824 W. LAMAR ALEXANDER PKWY
Practice Address - Street 2:
Practice Address - City:MARYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37801
Practice Address - Country:US
Practice Address - Phone:865-379-7004
Practice Address - Fax:865-719-7004
Is Sole Proprietor?:No
Enumeration Date:2014-06-17
Last Update Date:2016-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR3992122300000X
TN10211122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist