| Implant Dentistry Of The Mid South | |
|
1000 Brookfield Rd Suite 104 Memphis TN 38119-0802 | |
| (901) 767-3259 | |
| (901) 683-4756 |
| Full Name | Implant Dentistry Of The Mid South |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1000 Brookfield Rd, Memphis, Tennessee |
| Authorized Official Name and Position | John William Payonk (OWNER) |
| Authorized Official Contact | 9017673259 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Implant Dentistry Of The Mid South 1000 Brookfield Rd Suite 104 Memphis TN 38119-0802 Ph: (901) 683-4756 | Implant Dentistry Of The Mid South 1000 Brookfield Rd Suite 104 Memphis TN 38119-0802 Ph: (901) 767-3259 |
| NPI Number | 1003822842 |
|---|---|
| Provider Enumeration Date | 08/01/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003822842 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DS3315 (Tennessee) | Primary |
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