Individual
DR. CHADWICK HAGAN PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1633 W MAIN ST # 200, LEBANON, TN 37087-3423
(615) 449-3222
(615) 449-3202
Mailing address
1633 W MAIN ST # 200, LEBANON, TN 37087-3423
(615) 449-3222
(615) 449-3202
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8678
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1501181
—
TN
Enumeration date
10/03/2007
Last updated
07/12/2013
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