# ST. ELMO DENTAL

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023808565
- **Authorized official:** TAYLOR LAWSON (PRACTICE MANAGER)
- **Authorized official phone:** (423) 821-9771

## Contact information

- **Practice address:** 3918 TENNESSEE AVE STE 300, CHATTANOOGA, TN 37409-1352
- **Practice address phone:** (423) 821-9771
- **Practice address fax:** (423) 287-5588
- **Mailing address:** 3918 TENNESSEE AVE STE 300, CHATTANOOGA, TN 37409-1352
- **Mailing address phone:** (423) 821-9771
- **Mailing address fax:** (423) 287-5588

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 05/08/2025
- **Last updated:** 05/13/2025