MEDICARE: DR. WILLIAM SETLIFFE TEPPENPAW JR. DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	DS0000002651	TN

General Provider Information

NPI Number	:	1841393899
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM SETLIFFE TEPPENPAW JR. DDS

Provider Business Mailing Address
First Line	:	4841-B HIKSON PIKE
Second Line	:
City	:	CHATTANOOGA
State	:	TN
Zip	:	37343-4431
Country	:	US
Telephone Number	:	423-877-3544
Fax Number	:	423-875-6869

Provider Business Practice Location Address
First Line	:	4841-B HIXSON PIKE
Second Line	:
City	:	CHATTANOOGA
State	:	TN
Zip	:	37343-4431
Country	:	US
Telephone Number	:	423-877-3544
Fax Number	:	423-875-6869

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/06/2006
Last Update Date	:	07/08/2007

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