Organization
SOUTHSIDE DENTAL ARTS, LLC
Active
Other names
Smile Studio Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GEORGE MITCHELL BALDREE DDS (ORGANIZER/MANAGING MEMBER)
(423) 265-6685
Entity
Organization
Contact information
Practice address
200 W MAIN ST, CHATTANOOGA, TN 37408-1136
(423) 265-6685
(423) 265-8206
Mailing address
200 W MAIN ST, CHATTANOOGA, TN 37408-1136
(423) 265-6685
(423) 265-8206
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
DS005096
TN
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
DS005163
TN
Other
Enumeration date
07/05/2011
Last updated
12/31/2012
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