Organization
STANDIFER ORTHODONTICS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DENNIS W STANDIFER DDS (OWNER/PRESIDENT)
(423) 877-6485
Entity
Organization
Contact information
Practice address
1724 HAMILL RD, SUITE 202, HIXSON, TN 37343-5152
(423) 877-6485
Mailing address
1724 HAMILL RD, SUITE 202, HIXSON, TN 37343-5152
(423) 877-6485
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
4021
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q001383
—
TN
Enumeration date
11/30/2016
Last updated
12/05/2016
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