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General NPI Number Information
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NPI Number | 1619064391
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Entity Type | Organization
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Legal Business Name | DWAYNE B. MCCAMISH DDS MS PC
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Dates
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Enumeration Date | 10/06/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4610 BRAINERD ROAD
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City | CHATTANOOGA
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State | TN
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Zip | 37411
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Country | US
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Telephone | 423-622-4173
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Fax | 423-629-9889
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Provider Business Mailing Address
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Address Line | 4610 BRAINERD ROAD
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City | CHATTANOOGA
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State | TN
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Zip | 37411
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Country | US
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Telephone | 423-622-4173
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Fax | 423-629-9889
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DEWAYNE B. MCCAMISH
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Credential | DDS, MS
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Telephone | 423-622-4173
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | DS2208
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License Number State | TN
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