Organization
ASPIRE ORTHODONTICS, PC
Active
Other names
Aspire Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL GREY WEATHERSBY DDS, MDS (SHAREHOLDER)
(423) 238-1494
Entity
Organization
Contact information
Practice address
5913 OOLTEWAH RINGGOLD RD # 103, OOLTEWAH, TN 37363-7809
(423) 238-1494
(423) 238-1495
Mailing address
5913 OOLTEWAH RINGGOLD RD # 103, OOLTEWAH, TN 37363-7809
(423) 238-1494
(423) 238-1495
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
2561
TN
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
8131
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1515343
—
TN
01
—
3207077
TENNCARE
TN
01
—
5441630
TENNCARE
TN
Enumeration date
11/02/2009
Last updated
02/04/2010
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