# TENNESSEE DENTAL PROFESSIONALS PC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** TENNESSEE DENTAL PROFESSIONALS PC
- **Other names:** Great Southern Smiles
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1487057162
- **Legal business name:** TENNESSEE DENTAL PROFESSIONALS PC
- **Authorized official:** BELINDA HUERTA (CREDENTIALING COORDINATOR)
- **Authorized official phone:** (217) 540-2100

## Contact information

- **Practice address:** 9407 POPLAR AVE, GERMANTOWN, TN 38138-8003
- **Practice address phone:** (901) 309-6821
- **Mailing address:** 9407 POPLAR AVE, GERMANTOWN, TN 38138-8003
- **Mailing address phone:** (901) 309-6821

## Taxonomy

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

## Other

- **Enumeration date:** 10/08/2014
- **Last updated:** 03/15/2023