| Chattanooga Dental Center | |
|
7044 Lee Hwy Chattanooga TN 37421-1730 | |
| (423) 894-0650 | |
| (423) 894-0720 |
| Full Name | Chattanooga Dental Center |
|---|---|
| Speciality | Dentist |
| Location | 7044 Lee Hwy, Chattanooga, Tennessee |
| Authorized Official Name and Position | Bradley Walker Sundstrom (OWNER) |
| Authorized Official Contact | 4238940650 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Chattanooga Dental Center 7044 Lee Hwy Chattanooga TN 37421-1730 Ph: (423) 894-0650 | Chattanooga Dental Center 7044 Lee Hwy Chattanooga TN 37421-1730 Ph: (423) 894-0650 |
| NPI Number | 1184762684 |
|---|---|
| Provider Enumeration Date | 02/05/2007 |
| Last Update Date | 10/30/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184762684 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | D57688 (Tennessee) | Primary |
| 122300000X | Dentist | D53493 (Tennessee) | Secondary |
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