Healthcare Provider Details

I. General information

NPI: 1639210230
Provider Name (Legal Business Name): THE DENTAL OFFICE AT SADDLE CREEK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7535 POPLAR AVE
GERMANTOWN TN
38138-3812
US

IV. Provider business mailing address

7535 POPLAR AVE
GERMANTOWN TN
38138-3812
US

V. Phone/Fax

Practice location:
  • Phone: 901-754-4200
  • Fax: 901-754-5309
Mailing address:
  • Phone: 901-754-4200
  • Fax: 901-754-5309

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State

VIII. Authorized Official

Name: MR. GEORGE GUILFORD TAYLOR III
Title or Position: PRACTICE MGR.
Credential: MHA
Phone: 901-754-4200