Organization
JAMES E. LARSON DDS, MSD
Active
Other names
Greater Chattanooga Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES E LARSON DDS, MSD (OWNER)
(423) 296-0407
Entity
Organization
Contact information
Practice address
1829 GUNBARREL RD, SUITE A, CHATTANOOGA, TN 37421-7184
(423) 296-0407
(423) 296-0174
Mailing address
PO BOX 28047, CHATTANOOGA, TN 37424-8047
(423) 296-0407
(423) 296-0174
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
4503
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0007286
—
TN
05
—
000815988B
—
GA
Enumeration date
07/30/2015
Last updated
07/30/2015
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