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General NPI Number Information
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NPI Number | 1467562314
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Entity Type | Organization
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Legal Business Name | DENTAL EXCELLENCE PC
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 02/19/2013
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Provider Practice Location Address
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Address Line | 5180 PARK AVE STE 310
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City | MEMPHIS
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State | TN
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Zip | 38119-3531
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Country | US
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Telephone | 901-685-1152
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Fax | 901-682-6846
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Provider Business Mailing Address
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Address Line | 5180 PARK AVE STE 310
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City | MEMPHIS
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State | TN
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Zip | 38119-3531
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Country | US
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Telephone | 901-685-1152
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Fax | 901-682-6846
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Authorized Official
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Title or Position | PRES
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Name | DR. STEPHEN J LINDSEY
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Credential | DDS
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Telephone | 901-685-1152
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 3919
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License Number State | TN
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