Individual
DR. TED W. GAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
187 N GRUNDY QUARLES HWY, GAINESBORO, TN 38562-9691
(931) 268-2869
(931) 268-9837
Mailing address
240 CHERRY LN, GAINESBORO, TN 38562-5538
(931) 268-2597
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS0000003304
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0026412
BLUE CROSS BLUE SHIELD
TN
Enumeration date
01/31/2007
Last updated
07/08/2007
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