Provider Demographics
NPI:1043458763
Name:STEPHEN M. SAWRIE, D.D.S., M.S.
Entity type:Organization
Organization Name:STEPHEN M. SAWRIE, D.D.S., M.S.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:MALONE
Authorized Official - Last Name:SAWRIE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:423-624-8217
Mailing Address - Street 1:4727 BRAINERD RD
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37411-3828
Mailing Address - Country:US
Mailing Address - Phone:423-624-8217
Mailing Address - Fax:423-629-5170
Practice Address - Street 1:4727 BRAINERD RD
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37411-3828
Practice Address - Country:US
Practice Address - Phone:423-624-8217
Practice Address - Fax:423-629-5170
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-03
Last Update Date:2009-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS22951223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty