# PAYNE FAMILY DENTISTRY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1699062273
- **Authorized official:** DR. ADRIENNE M JACKSON-PAYNE D.D.S (DENTIST/OWNER)
- **Authorized official phone:** (901) 365-9054

## Contact information

- **Practice address:** 3574 HICKORY HILL RD, MEMPHIS, TN 38115-3827
- **Practice address phone:** (901) 365-9054
- **Mailing address:** 3574 HICKORY HILL RD, MEMPHIS, TN 38115-3827
- **Mailing address phone:** (901) 365-9054

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 5420 | MO | — |
| 1223G0001X | General Practice Dentistry | 7038 | TN | Yes |

## Other

- **Enumeration date:** 07/05/2011
- **Last updated:** 07/05/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1881777670 | — | TN |
| 05 | — | 1992884845 | — | TN |