| Premium Care Dentistry | |
|
1331 Union Ave Ste 1240 Memphis TN 38104-7552 | |
| (901) 730-1321 | |
| (901) 730-1382 |
| Full Name | Premium Care Dentistry |
|---|---|
| Speciality | Dentist |
| Location | 1331 Union Ave Ste 1240, Memphis, Tennessee |
| Authorized Official Name and Position | Joe D O'neal (OWNER) |
| Authorized Official Contact | 9017301321 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Premium Care Dentistry 1331 Union Avenue #1240 Memphis TN 38104-7551 Ph: (901) 730-1321 | Premium Care Dentistry 1331 Union Ave Ste 1240 Memphis TN 38104-7552 Ph: (901) 730-1321 |
| NPI Number | 1336513597 |
|---|---|
| Provider Enumeration Date | 11/25/2015 |
| Last Update Date | 11/25/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336513597 | NPI | - | NPPES |
| 3225297 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 3438 (Tennessee) | Primary |
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