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9407 Poplar Ave Germantown TN 38138-8003 | |
| (901) 309-6821 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 9407 Poplar Ave, Germantown, Tennessee |
| Authorized Official Name and Position | Belinda Huerta (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 2175402100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
9407 Poplar Ave Germantown TN 38138-8003 Ph: (901) 309-6821 | 9407 Poplar Ave Germantown TN 38138-8003 Ph: (901) 309-6821 |
| NPI Number | 1487057162 |
|---|---|
| Provider Enumeration Date | 10/08/2014 |
| Last Update Date | 03/15/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487057162 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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