| Greater Chattanooga Orthodontics | |
|
1829 Gunbarrel Rd Suite A Chattanooga TN 37421-7184 | |
| (423) 296-0407 | |
| (423) 296-0174 |
| Full Name | Greater Chattanooga Orthodontics |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 1829 Gunbarrel Rd, Chattanooga, Tennessee |
| Authorized Official Name and Position | James E Larson (OWNER) |
| Authorized Official Contact | 4232960407 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Greater Chattanooga Orthodontics Po Box 28047 Chattanooga TN 37424-8047 Ph: (423) 296-0407 | Greater Chattanooga Orthodontics 1829 Gunbarrel Rd Suite A Chattanooga TN 37421-7184 Ph: (423) 296-0407 |
| NPI Number | 1578948683 |
|---|---|
| Provider Enumeration Date | 07/30/2015 |
| Last Update Date | 07/30/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578948683 | NPI | - | NPPES |
| 000815988B | Medicaid | GA | |
| 0007286 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 4503 (Tennessee) | Primary |
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