CLINT OLE BRODAL

MARYVILLE, TN
NPI1720235781
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1223P0221X Dentist, Pediatric Dentistry
(Licence: TN  10289)
Additional Taxonomies122300000X Dentist
(Licence: OR  D9259)
390200000X Student in an Organized Health Care Education/Training Program
(Licence: OR  D9259)
Enumeration Date2008-08-21
Last Update Date2016-07-08
Business Address
Dr. CLINT OLE BRODAL DMD
121 PARLIAMENT DR
MARYVILLE, TN 37804-6210
Phone number: 865-977-8700
Mailing Address
Dr. CLINT OLE BRODAL DMD
121 PARLIAMENT DR
MARYVILLE, TN 37804-6210
Phone number: 865-977-8700