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General NPI Number Information
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NPI Number | 1942213319
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Entity Type | Individual
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Provider Name | CORDELL H. CHAFFIN D.D.S
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Gender | Male
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Dates
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Enumeration Date | 08/15/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 107 IMPERIAL BLVD STE 12
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City | HENDERSONVILLE
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State | TN
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Zip | 37075-3441
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Country | US
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Telephone | 615-824-2013
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Fax | 615-824-1558
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Provider Business Mailing Address
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Address Line | 101 GOLF VIEW DR
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City | HENDERSONVILLE
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State | TN
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Zip | 37075-8549
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Country | US
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Telephone | 615-824-7709
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | DS-1910
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License Number State | TN
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