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General NPI Number Information
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NPI Number | 1629702451
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Entity Type | Individual
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Provider Name | ANDREW MCCORMACK DENNING DDS
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Gender | Male
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Dates
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Enumeration Date | 07/16/2022
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Last Update Date | 07/16/2022
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Provider Practice Location Address
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Address Line | 6888 GOODMAN RD STE 123
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City | OLIVE BRANCH
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State | MS
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Zip | 38654-8761
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Country | US
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Telephone | 662-268-6539
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Fax |
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Provider Business Mailing Address
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Address Line | 1617 FAXON AVE
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City | MEMPHIS
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State | TN
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Zip | 38112-4920
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Country | US
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Telephone | 404-790-4224
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 12004
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License Number State | TN
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