Southeastern Dental Associates of Soddy Daisy

NPI #1790821148 in Soddy Daisy, Tennessee

Provider Information

NPI Number: 1790821148
Entity Type: Organization
Organization Name: Southeastern Dental Associates of Soddy Daisy
Primary Specialty: Dentist
Enumeration Date: Jan 30, 2007
Last Updated: Apr 16, 2013

Practice Location

Address: 124 HARRISON LN
Address 2: SUITE 100
City: Soddy Daisy
State: Tennessee
ZIP Code: 37379-4831
Phone: (423) 332-0500

Authorized Official

Name: DR. NICHOLAS EUGENE BOWMAN, D.M.D.
Title: PRESIDENT
Phone: (423) 332-0500

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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