Provider Demographics
NPI:1992830418
Name:SAWRIE, STEPHEN MALONE (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:MALONE
Last Name:SAWRIE
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3635 KINGS RD
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37416-2012
Mailing Address - Country:US
Mailing Address - Phone:423-698-2808
Mailing Address - Fax:
Practice Address - Street 1:4727 BRAINERD RD
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37411-3828
Practice Address - Country:US
Practice Address - Phone:423-624-8217
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS22951223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics