Provider Demographics
NPI:1932789880
Name:KIDS DENTAL CENTER, GP
Entity Type:Organization
Organization Name:KIDS DENTAL CENTER, GP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PEDIATRIC DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:ESLINGER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:423-541-5500
Mailing Address - Street 1:4610 BRAINERD RD STE 3
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37411-3835
Mailing Address - Country:US
Mailing Address - Phone:423-541-5500
Mailing Address - Fax:423-476-2680
Practice Address - Street 1:165 MOUSE CREEK RD NW
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37312-3818
Practice Address - Country:US
Practice Address - Phone:423-458-4147
Practice Address - Fax:423-476-2680
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-13
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty