Provider Demographics
NPI:1508857236
Name:RATLIFF, CYNTHIA JO (DMD)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:JO
Last Name:RATLIFF
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 ROBIN RD
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:TN
Mailing Address - Zip Code:37620-2718
Mailing Address - Country:US
Mailing Address - Phone:423-968-7521
Mailing Address - Fax:423-989-3094
Practice Address - Street 1:332 6TH ST
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:TN
Practice Address - Zip Code:37620-2201
Practice Address - Country:US
Practice Address - Phone:423-989-3000
Practice Address - Fax:423-989-3094
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7940122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist