Provider Demographics
NPI:1346459385
Name:CHAMBERLAND DENTISTRY PC
Entity Type:Organization
Organization Name:CHAMBERLAND DENTISTRY PC
Other - Org Name:SHELBYVILLE FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAM
Authorized Official - Middle Name:A
Authorized Official - Last Name:CHAMBERLAND
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:931-684-9167
Mailing Address - Street 1:1006 COLLOREDO BLVD
Mailing Address - Street 2:
Mailing Address - City:SHELBYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37160
Mailing Address - Country:US
Mailing Address - Phone:931-684-9167
Mailing Address - Fax:931-684-9633
Practice Address - Street 1:1006 COLLOREDO BLVD
Practice Address - Street 2:
Practice Address - City:SHELBYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37160
Practice Address - Country:US
Practice Address - Phone:931-684-9167
Practice Address - Fax:931-684-9633
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2016-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS0000007464305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes305R00000XManaged Care OrganizationsPreferred Provider OrganizationGroup - Single Specialty