Provider Demographics
NPI:1053482497
Name:FOWLER, CHAD ERIC (DDS, MSD)
Entity Type:Individual
Prefix:DR
First Name:CHAD
Middle Name:ERIC
Last Name:FOWLER
Suffix:
Gender:M
Credentials:DDS, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:511 NEW HIGHWAY 96 W
Mailing Address - Street 2:SUITE 203
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37064-2470
Mailing Address - Country:US
Mailing Address - Phone:615-591-4770
Mailing Address - Fax:
Practice Address - Street 1:511 NEW HIGHWAY 96 W
Practice Address - Street 2:SUITE 203
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37064-2470
Practice Address - Country:US
Practice Address - Phone:615-591-4770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2007-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN86341223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics