# AMERICAN FAMILY DENTISTRY OF MEMPHIS, PC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** AMERICAN FAMILY DENTISTRY OF MEMPHIS, PC
- **Other names:** American Family Dentistry - Kirby Quince
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1790446508
- **Legal business name:** AMERICAN FAMILY DENTISTRY OF MEMPHIS, PC
- **Authorized official:** CELIA HAYES (CREDENTIALING COORDINATOR)
- **Authorized official phone:** (217) 540-2100

## Contact information

- **Practice address:** 2900 KIRBY RD STE 12, MEMPHIS, TN 38119-8207
- **Practice address phone:** (901) 756-8976
- **Practice address fax:** (901) 756-8547
- **Mailing address:** 2900 KIRBY RD STE 12, MEMPHIS, TN 38119-8207
- **Mailing address phone:** (901) 756-8976

## Taxonomy

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

## Other

- **Enumeration date:** 01/04/2022
- **Last updated:** 06/28/2023