| Pediatric Dentistry Of Chattanooga, Pllc | |
|
150 Stuart Crossing Cleveland TN 37312-4065 | |
| (423) 541-5500 | |
| (423) 476-2680 |
| Full Name | Pediatric Dentistry Of Chattanooga, Pllc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 150 Stuart Crossing, Cleveland, Tennessee |
| Authorized Official Name and Position | Sommer Nicole Maynor (CREDENTIALING MGR) |
| Authorized Official Contact | 4235415427 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pediatric Dentistry Of Chattanooga, Pllc P.o. Box 4078 Cleveland TN 37320-4078 Ph: (423) 541-5500 | Pediatric Dentistry Of Chattanooga, Pllc 150 Stuart Crossing Cleveland TN 37312-4065 Ph: (423) 541-5500 |
| NPI Number | 1851655187 |
|---|---|
| Provider Enumeration Date | 07/02/2012 |
| Last Update Date | 05/06/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851655187 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Secondary |
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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