| East Brainerd Oral Surgery | |
|
1350 Mackey Branch Drive St. 110 Chattanooga TN 37421-3482 | |
| (423) 296-8210 | |
| (423) 296-8292 |
| Full Name | East Brainerd Oral Surgery |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 1350 Mackey Branch Drive, Chattanooga, Tennessee |
| Authorized Official Name and Position | Jennifer Lynn Brown (OFFICE MANAGER) |
| Authorized Official Contact | 4232968210 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| East Brainerd Oral Surgery 1350 Mackey Branch Drive St. 110 Chattanooga TN 37421 Ph: (423) 396-8210 | East Brainerd Oral Surgery 1350 Mackey Branch Drive St. 110 Chattanooga TN 37421-3482 Ph: (423) 296-8210 |
| NPI Number | 1851691281 |
|---|---|
| Provider Enumeration Date | 11/02/2010 |
| Last Update Date | 09/30/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851691281 | NPI | - | NPPES |
| 1521422 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (Tennessee) | Primary |
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