Provider Demographics
NPI:1033123344
Name:DRESSLER, KEITH B (DDS,MSD)
Entity type:Individual
Prefix:DR
First Name:KEITH
Middle Name:B
Last Name:DRESSLER
Suffix:
Gender:M
Credentials:DDS,MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6820 LEE HWY
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-2444
Mailing Address - Country:US
Mailing Address - Phone:423-894-6318
Mailing Address - Fax:423-894-8613
Practice Address - Street 1:6820 LEE HWY
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-2444
Practice Address - Country:US
Practice Address - Phone:423-894-6318
Practice Address - Fax:423-894-8613
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-29
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS41621223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN5581960001Medicare NSC