# CROSSTOWN DENTAL GROUP LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Crosstown Dental Group LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1467068569
- **Authorized official:** DANIEL BIRD DDS (OWNER/DENTIST)
- **Authorized official phone:** (901) 881-1234

## Contact information

- **Practice address:** 1350 CONCOURSE AVE STE 446, MEMPHIS, TN 38104-2026
- **Practice address phone:** (901) 881-1234
- **Practice address fax:** (901) 339-5995
- **Mailing address:** 1350 CONCOURSE AVE STE 446, MEMPHIS, TN 38104-2026
- **Mailing address phone:** (901) 881-1234
- **Mailing address fax:** (901) 339-5995

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 09/23/2020
- **Last updated:** 09/23/2020