Organization
CD TENNESSEE DENTAL, P.C.
Active
Other names
Chattanooga Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
TY V. JUSTICE (DIRECTOR, CREDENTIALING)
(513) 609-4076
Entity
Organization
Contact information
Practice address
6102 SHALLOWFORD RD STE 101, CHATTANOOGA, TN 37421-1684
(423) 499-9300
(423) 499-9746
Mailing address
9825 KENWOOD RD STE 200, BLUE ASH, OH 45242-6252
(513) 609-4076
(513) 448-0511
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
01/05/2018
Last updated
05/03/2023
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