Individual
DR. DAVID R CHEATHAM
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.S.
Contact information
Practice address
1754 MADISON ST, SUITE 4, CLARKSVILLE, TN 37043-2923
(931) 647-0838
(931) 648-3840
Mailing address
1754 MADISON ST, SUITE 4, CLARKSVILLE, TN 37043-2923
(931) 647-0838
(931) 648-3840
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DS4516
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0123261
BLUE CROSS BLUE SHIELD
TN
05
—
3225441
—
TN
Enumeration date
08/22/2005
Last updated
07/08/2007
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