Healthcare Provider Details

I. General information

NPI: 1508761834
Provider Name (Legal Business Name): PROFESSIONAL SMILES AESTHETICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2026
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 PROFESSIONAL PLZ
GERMANTOWN TN
38138-7915
US

IV. Provider business mailing address

3100 PROFESSIONAL PLZ
GERMANTOWN TN
38138-7915
US

V. Phone/Fax

Practice location:
  • Phone: 901-295-2995
  • Fax: 901-249-6179
Mailing address:
  • Phone: 901-295-2995
  • Fax: 901-249-6179

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. ANTHONY V PRICE
Title or Position: CEO/OWNER
Credential: DDS
Phone: 901-295-2995