Provider Demographics
NPI:1982008868
Name:FREEMAN C. DOSTER DDS
Entity type:Organization
Organization Name:FREEMAN C. DOSTER DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FREEMAN
Authorized Official - Middle Name:CROSS
Authorized Official - Last Name:DOSTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-265-8839
Mailing Address - Street 1:1001 CARTER STREET
Mailing Address - Street 2:SUITE B
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37402
Mailing Address - Country:US
Mailing Address - Phone:423-265-8839
Mailing Address - Fax:423-267-0158
Practice Address - Street 1:1001 CARTER STREET
Practice Address - Street 2:SUITE B
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37402
Practice Address - Country:US
Practice Address - Phone:423-265-8839
Practice Address - Fax:423-267-0158
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-21
Last Update Date:2014-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS3966122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty