MEDICARE: DR. DAVID G WARD DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	DS0000005263	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	145809	OTHER	TN	BCBS OF TENN

General Provider Information

NPI Number	:	1851351449
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID G WARD DDS

Provider Business Mailing Address
First Line	:	2190 CHAMBLISS AVE NW
Second Line	:
City	:	CLEVELAND
State	:	TN
Zip	:	37311-3839
Country	:	US
Telephone Number	:	423-476-3307
Fax Number	:	423-476-2110

Provider Business Practice Location Address
First Line	:	2190 CHAMBLISS AVE NE
Second Line	:
City	:	CLEVELAND
State	:	TN
Zip	:	37311-3839
Country	:	US
Telephone Number	:	423-476-3307
Fax Number	:	423-476-2110

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/27/2006
Last Update Date	:	07/08/2007

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