Provider Demographics
NPI:1992965594
Name:CORRIGAN, KRISTEN LYNN (DMD)
Entity type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:LYNN
Last Name:CORRIGAN
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 1:6860 MANASSAS GAP LANE
Mailing Address - Street 2:
Mailing Address - City:HIXSON
Mailing Address - State:TN
Mailing Address - Zip Code:37343
Mailing Address - Country:US
Mailing Address - Phone:423-238-9653
Mailing Address - Fax:423-238-5786
Practice Address - Street 1:9203 LEE HWY
Practice Address - Street 2:SUITE 16
Practice Address - City:OOLTEWAH
Practice Address - State:TN
Practice Address - Zip Code:37363-4412
Practice Address - Country:US
Practice Address - Phone:423-238-9653
Practice Address - Fax:423-238-5786
Is Sole Proprietor?:No
Enumeration Date:2008-06-17
Last Update Date:2010-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS8842122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist