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General NPI Number Information
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NPI Number | 1992921381
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Entity Type | Organization
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Legal Business Name | SMILE MAKERS OF MEMPHIS PC
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Dates
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Enumeration Date | 04/17/2007
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Last Update Date | 01/04/2012
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Provider Practice Location Address
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Address Line | 2900 KIRBY PARKWAY SUITE #9
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City | MEMPHIS
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State | TN
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Zip | 38119-8221
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Country | US
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Telephone | 901-755-7392
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Fax | 901-755-6442
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Provider Business Mailing Address
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Address Line | 2900 KIRBY RD SUITE #9
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City | MEMPHIS
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State | TN
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Zip | 38119-8221
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Country | US
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Telephone | 901-755-7392
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Fax | 901-755-6442
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Authorized Official
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Title or Position | OPERATIONS MANAGER
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Name | MRS. PAMELA ARLEEN PRICE
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Credential | B.S.
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Telephone | 901-755-7392
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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 |
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License Number State |
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