Provider Demographics
NPI:1144775305
Name:AUGUSTY, CHADWICK (DMD)
Entity Type:Individual
Prefix:
First Name:CHADWICK
Middle Name:
Last Name:AUGUSTY
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1908 BEECHVILLE TER
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-4826
Mailing Address - Country:US
Mailing Address - Phone:615-390-8313
Mailing Address - Fax:
Practice Address - Street 1:4219 HILLSBORO PIKE
Practice Address - Street 2:SUITE 105
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37215-3328
Practice Address - Country:US
Practice Address - Phone:615-645-1315
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-17
Last Update Date:2016-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN10345122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist