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Organization
DENTAL PRACTICE GROUP OF TENNESSEE
Active
Organization
DENTAL PRACTICE GROUP OF TENNESSEE
Active
Parent organization
DENTAL PRACTICE GROUP OF TENNESSEE
Other names
Brookhaven Family Dentistry
Organization subpart
Yes
Provider details
NPI number
Legal business name
DENTAL PRACTICE GROUP OF TENNESSEE
Authorized official
NANCY SCHIAPARELLI (CHIEF FINANCIAL OFFICER)
(727) 800-8040
Entity
Organization
Contact information
Practice address
775 E BROOKHAVEN CIR, MEMPHIS, TN 38117-4501
(901) 682-3100
(901) 682-9848
Mailing address
136 4TH ST N STE 201, ST PETERSBURG, FL 33701-3889
(727) 800-8026
(727) 304-3164
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100178860
—
KY
05
—
Q011942
—
TN
Enumeration date
08/16/2012
Last updated
03/30/2023
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