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General NPI Number Information
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NPI Number | 1992830418
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Entity Type | Individual
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Provider Name | STEPHEN MALONE SAWRIE DDS, MS
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Gender | Male
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Dates
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Enumeration Date | 02/23/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4727 BRAINERD RD
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City | CHATTANOOGA
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State | TN
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Zip | 37411-3828
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Country | US
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Telephone | 423-624-8217
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Fax |
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Provider Business Mailing Address
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Address Line | 3635 KINGS RD
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City | CHATTANOOGA
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State | TN
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Zip | 37416-2012
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Country | US
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Telephone | 423-698-2808
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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 | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | DS2295
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License Number State | TN
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