# GERMANTOWN DENTAL GROUP

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Whittemore-Gruen, PLLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003927310
- **Authorized official:** MRS. BETHANY OLIVER FOSTER (OFFICE MANAGER)
- **Authorized official phone:** (901) 754-0540

## Contact information

- **Practice address:** 2165 WEST ST, GERMANTOWN, TN 38138
- **Practice address phone:** (901) 754-0540
- **Practice address fax:** (901) 754-0621
- **Mailing address:** 2165 WEST ST, GERMANTOWN, TN 38138
- **Mailing address phone:** (901) 754-0540
- **Mailing address fax:** (901) 754-0621

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | DS2834 | TN | Yes |
| 261QD0000X | Dental Clinic/Center | DS3429 | TN | — |
| 261QD0000X | Dental Clinic/Center | DS7364 | TN | — |
| 261QD0000X | Dental Clinic/Center | DS7426 | TN | — |

## Other

- **Enumeration date:** 08/31/2006
- **Last updated:** 10/24/2007