Organization
SCENIC CITY ORTHODONTICS PC
Active
Organization
SCENIC CITY ORTHODONTICS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TYLER PRENTICE D.M.D., M.S. (PRESIDENT)
(423) 855-4201
Entity
Organization
Contact information
Practice address
7003 SHALLOWFORD RD, CHATTANOOGA, TN 37421-6722
(423) 855-4201
(423) 855-4203
Mailing address
7003 SHALLOWFORD RD, CHATTANOOGA, TN 37421-6722
(423) 855-4201
(423) 855-4203
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
9065
TN
Other
Enumeration date
08/23/2010
Last updated
08/23/2010
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