Provider Demographics
NPI:1811325483
Name:HARVILLE, JENNIFER NOTTINGHAM (DMD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:NOTTINGHAM
Last Name:HARVILLE
Suffix:
Gender:F
Credentials:DMD
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Mailing Address - Street 1:2025 MEADOVIEW PARKWAY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:KINGSPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37660
Mailing Address - Country:US
Mailing Address - Phone:423-247-5137
Mailing Address - Fax:423-392-8595
Practice Address - Street 1:2025 MEADOVIEW PARKWAY
Practice Address - Street 2:SUITE 200
Practice Address - City:KINGSPORT
Practice Address - State:TN
Practice Address - Zip Code:37660
Practice Address - Country:US
Practice Address - Phone:423-247-5137
Practice Address - Fax:423-392-8595
Is Sole Proprietor?:No
Enumeration Date:2013-10-17
Last Update Date:2013-10-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN97541223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics