Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | DS4162 | TN |
NPI | 1033123344 |
---|---|
Provider Name | Dr. Keith B Dressler |
First Address | Chattanooga, TN 37421-2444 |
Second Address | Chattanooga, TN 37421-2444 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/07/2006 |
Last Update Date | 18/06/2008 |