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General NPI Number Information
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NPI Number | 1942510979
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Entity Type | Organization
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Legal Business Name | MCDANIEL ORTHODONTICS, P.C.
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Dates
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Enumeration Date | 10/08/2010
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Last Update Date | 10/08/2010
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Provider Practice Location Address
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Address Line | 951 RIVERFRONT PKWY SUITE 202
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City | CHATTANOOGA
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State | TN
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Zip | 37402-2185
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Country | US
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Telephone | 423-266-8614
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Fax | 423-265-0429
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Provider Business Mailing Address
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Address Line | 951 RIVERFRONT PKWY SUITE 202
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City | CHATTANOOGA
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State | TN
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Zip | 37402-2185
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SECRETARY
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Name | DR. ANDREW MCDANIEL
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Credential | D.D.S., M.S.
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Telephone | 423-266-8614
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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 | DS8122
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License Number State | TN
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