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General NPI Number Information
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NPI Number | 1356701163
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Entity Type | Organization
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Legal Business Name | CHESNEY DENTISTRY NORTH
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Dates
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Enumeration Date | 03/07/2016
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Last Update Date | 03/07/2016
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Provider Practice Location Address
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Address Line | 3019 SANDERS DR
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City | KNOXVILLE
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State | TN
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Zip | 37918-1867
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Country | US
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Telephone | 865-688-4112
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Fax | 865-689-8460
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Provider Business Mailing Address
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Address Line | 3019 SANDERS DR
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City | KNOXVILLE
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State | TN
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Zip | 37918-1867
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Country | US
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Telephone | 865-688-4112
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Fax | 865-689-8460
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Authorized Official
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Title or Position | OWNER/CEO
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Name | DR. GARY CHESNEY
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Credential | D.D.S.
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Telephone | 865-966-7441
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 4180
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License Number State | TN
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