Provider Demographics
NPI:1982264479
Name:TN DENTAL PROFESSIONALS II PC
Entity Type:Organization
Organization Name:TN DENTAL PROFESSIONALS II PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ANALYST, REVENUE CYCLE MANAGEMENT
Authorized Official - Prefix:
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:
Authorized Official - Last Name:WORKMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-241-1931
Mailing Address - Street 1:PO BOX 306082
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37230-6082
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8703 E BRAINERD RD
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-4369
Practice Address - Country:US
Practice Address - Phone:423-893-7443
Practice Address - Fax:423-475-5514
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-17
Last Update Date:2019-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty