Provider Demographics
NPI:1316439581
Name:DAVIDSON, CHELSEA LYNN (DMD)
Entity type:Individual
Prefix:DR
First Name:CHELSEA
Middle Name:LYNN
Last Name:DAVIDSON
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 E ACORN DR
Mailing Address - Street 2:
Mailing Address - City:ROCK SPRING
Mailing Address - State:GA
Mailing Address - Zip Code:30739-4147
Mailing Address - Country:US
Mailing Address - Phone:423-653-3363
Mailing Address - Fax:
Practice Address - Street 1:7319 NASHVILLE ST
Practice Address - Street 2:
Practice Address - City:RINGGOLD
Practice Address - State:GA
Practice Address - Zip Code:30736-2425
Practice Address - Country:US
Practice Address - Phone:706-935-2206
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-04
Last Update Date:2018-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0156381223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice