Organization
PEDIATRIC DENTISTRY AND ORTHODONTICS OF CHATTANOOGA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH COOPER DYER IV DDS (CO-OWNER/ORTHODONTIST)
(423) 622-4173
Entity
Organization
Contact information
Practice address
4610 BRAINERD ROAD, SUITE 3, CHATTANOOGA, TN 37411
(423) 622-4173
(423) 629-9889
Mailing address
4610 BRAINERD ROAD, SUITE 3, CHATTANOOGA, TN 37411
(423) 622-4173
(423) 629-9889
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
—
—
1223P0221X
Pediatric Dentistry
Primary
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
Other
Enumeration date
01/31/2019
Last updated
01/31/2019
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