Individual
CALEB ODUM WIDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
350 BLOUNTVILLE HWY, BRISTOL, TN 37620-0213
(423) 968-9661
Mailing address
310 N LINDEN AVE, HENRICO, VA 23075-1902
(276) 698-9908
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
0401419359
VA
1223P0221X
Pediatric Dentistry
Primary
12783
TN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/05/2023
Last updated
06/04/2025
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