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Organization
IMPLANT DENTISTRY OF THE MID SOUTH
Active
Organization
IMPLANT DENTISTRY OF THE MID SOUTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN WILLIAM PAYONK D.D.S. (OWNER)
(901) 767-3259
Entity
Organization
Contact information
Practice address
1000 BROOKFIELD RD, SUITE 104, MEMPHIS, TN 38119-0802
(901) 767-3259
(901) 683-4756
Mailing address
1000 BROOKFIELD RD, SUITE 104, MEMPHIS, TN 38119-0802
(901) 683-4756
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS3315
TN
Other
Enumeration date
08/01/2006
Last updated
08/22/2020
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