Individual
SIMON CHANIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3071 KIRBY WHITTEN RD, BARTLETT, TN 38134-2822
(901) 382-1564
Mailing address
137 E GE PATTERSON AVE APT 102, MEMPHIS, TN 38103-4500
(901) 626-9480
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DS0000011186
TN
390200000X
Student in an Organized Health Care Education/Training Program
00000
OR
Other
Enumeration date
10/03/2017
Last updated
11/27/2023
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