Individual
DR. ERNEST JAMES DEWALD
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1301 PEACHERS MILL RD, CLARKSVILLE, TN 37042-4610
(931) 572-9152
(931) 572-9155
Mailing address
1301 PEACHERS MILL RD, CLARKSVILLE, TN 37042-4610
(931) 572-9152
(931) 572-9155
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
032522
NY
122300000X
Dentist
Primary
DS006850
TN
122300000X
Dentist
MD06299
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0018148
DORAL
—
01
—
0174736
BCBS OF TN
—
01
—
719384
UNITED CONCORDIA
—
Enumeration date
11/28/2005
Last updated
07/08/2007
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