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General NPI Number Information
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NPI Number | 1376419754
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Entity Type | Organization
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Legal Business Name | CORDOVA FAMILY DENTAL
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Dates
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Enumeration Date | 10/14/2025
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Last Update Date | 02/10/2026
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Provider Practice Location Address
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Address Line | 1680 BONNIE LN
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City | CORDOVA
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State | TN
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Zip | 38016-1529
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Country | US
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Telephone | 901-667-6453
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Fax | 901-742-2693
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Provider Business Mailing Address
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Address Line | 1680 BONNIE LN
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City | CORDOVA
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State | TN
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Zip | 38016-1529
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Country | US
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Telephone | 901-667-6453
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Fax | 901-742-2693
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Authorized Official
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Title or Position | DMD / OWNER
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Name | AARON KNOP
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Credential | DMD
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Telephone | 901-667-6453
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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