Provider Demographics
NPI:1417250432
Name:ASDENT CORPORATION
Entity Type:Organization
Organization Name:ASDENT CORPORATION
Other - Org Name:ASPIRE ECONOMY DENTURE AND DENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:C
Authorized Official - Last Name:RUMPH
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:423-622-4869
Mailing Address - Street 1:3210 WILCOX BLVD
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37411-1071
Mailing Address - Country:US
Mailing Address - Phone:423-622-4869
Mailing Address - Fax:423-622-4875
Practice Address - Street 1:1625 MCCALLIE AVE
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37404-3022
Practice Address - Country:US
Practice Address - Phone:423-622-4869
Practice Address - Fax:423-622-4875
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-13
Last Update Date:2010-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4119DS122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00940805AMedicaid
TN4652Medicaid