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NPI Code Detail

MEDICARE: FAMILY AND COSMETIC DENTISTRY OF MEMPHIS, PLLC

MEDICARE: FAMILY AND COSMETIC DENTISTRY OF MEMPHIS, PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice DentistryDS7245TN

General Provider Information

NPI Number : 1114299401
Entity Type Code : Organization
Provider Name (Legal Business Name) : FAMILY AND COSMETIC DENTISTRY OF MEMPHIS, PLLC
Provider Business Mailing Address
First Line : 845 S HIGHLAND ST
Second Line :
City : MEMPHIS
State : TN
Zip : 38111-4254
Country : US
Telephone Number : 901-323-8488
Fax Number :
Provider Business Practice Location Address
First Line : 845 S HIGHLAND ST
Second Line :
City : MEMPHIS
State : TN
Zip : 38111-4254
Country : US
Telephone Number : 901-323-8488
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DR. MINESH Y PATEL
Credential : D.D.S.
Telephone Number : 901-323-8488
Provider Enumeration Date : 02/01/2012
Last Update Date : 02/29/2012

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