Provider Demographics
NPI:1306417928
Name:BRYANT, CHELSEA CAITLIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHELSEA
Middle Name:CAITLIN
Last Name:BRYANT
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:CHELSEA
Other - Middle Name:CAITLIN
Other - Last Name:GILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:240 S PETERS RD STE 103
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923-5226
Mailing Address - Country:US
Mailing Address - Phone:336-404-0653
Mailing Address - Fax:
Practice Address - Street 1:240 S PETERS RD STE 103
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-5226
Practice Address - Country:US
Practice Address - Phone:336-404-0653
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-06
Last Update Date:2021-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN116031223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice