Provider Demographics
NPI:1598466260
Name:MICHAEL D VAUGHAN DDS AND ASSOCIATES OF CHATTANOOGA PLLC
Entity Type:Organization
Organization Name:MICHAEL D VAUGHAN DDS AND ASSOCIATES OF CHATTANOOGA PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:DARREN
Authorized Official - Last Name:VAUGHAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:615-397-4483
Mailing Address - Street 1:3429A 33RD AVE S
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37212-4001
Mailing Address - Country:US
Mailing Address - Phone:615-397-4483
Mailing Address - Fax:
Practice Address - Street 1:5959 SHALLOWFORD RD STE 539
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-2240
Practice Address - Country:US
Practice Address - Phone:425-325-9700
Practice Address - Fax:423-325-9701
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MICHAEL D VAUGHAN DDS PLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-03-10
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty