Organization
PROFESSIONAL MEDICAL PROPERTIES, LLC
Active
Other names
Center for Oral Facial and Implant Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WAYNE E TIPPS DDS (PRESIDENT/PARTNER)
(423) 893-3333
Entity
Organization
Contact information
Practice address
6015 SHALLOWFORD ROAD, CHATTANOOGA, TN 37421-1688
(423) 954-9180
(423) 954-3054
Mailing address
6015 SHALLOWFORD ROAD, CHATTANOOGA, TN 37421-1688
(423) 893-3333
(423) 954-3054
Taxonomy
Speciality
Code
Description
License number
State
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
1224
TN
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3287837
—
TN
Enumeration date
10/03/2006
Last updated
04/04/2018
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