| Payne Family Dentistry | |
|
3574 Hickory Hill Rd Memphis TN 38115-3827 | |
| (901) 365-9054 | |
| Not Available |
| Full Name | Payne Family Dentistry |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 3574 Hickory Hill Rd, Memphis, Tennessee |
| Authorized Official Name and Position | Adrienne M Jackson-payne (DENTIST/OWNER) |
| Authorized Official Contact | 9013659054 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Payne Family Dentistry 3574 Hickory Hill Rd Memphis TN 38115-3827 Ph: (901) 365-9054 | Payne Family Dentistry 3574 Hickory Hill Rd Memphis TN 38115-3827 Ph: (901) 365-9054 |
| NPI Number | 1699062273 |
|---|---|
| Provider Enumeration Date | 07/05/2011 |
| Last Update Date | 07/05/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699062273 | NPI | - | NPPES |
| 1881777670 | Medicaid | TN | |
| 1992884845 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 5420 (Missouri) | Secondary |
| 1223G0001X | Dentist - General Practice | 7038 (Tennessee) | Primary |
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