Provider Demographics
NPI:1245585421
Name:DOSTER, FREEMAN CROSS JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:FREEMAN
Middle Name:CROSS
Last Name:DOSTER
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 CARTER ST STE B
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37402-5094
Mailing Address - Country:US
Mailing Address - Phone:423-265-8839
Mailing Address - Fax:
Practice Address - Street 1:1001 CARTER ST STE B
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37402-5094
Practice Address - Country:US
Practice Address - Phone:423-265-8839
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-13
Last Update Date:2012-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN9499122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist