Individual
DR. LARRY CHAMBERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
3067 N HIGHLAND AVE, JACKSON, TN 38305-3411
(731) 668-7916
Mailing address
35 RIDGECREST DR., JACKSON, TN 38305
(731) 668-8907
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS4211
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0132345
BCBS/TN
TN
01
—
0149768
BCBS CORP ID#
TN
01
—
803388
UCCI
TN
Enumeration date
10/31/2006
Last updated
07/08/2007
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