Organization
THE ORTHODONTIC CLINIC, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ADEOLA O. FALEYE D.M.D. (CEO, OWNER)
(901) 377-1744
Entity
Organization
Contact information
Practice address
6637 SUMMER KNOLL CIR, SUITE 102, BARTLETT, TN 38134-2875
(901) 377-1744
(901) 507-4772
Mailing address
6637 SUMMER KNOLL CIR, SUITE 102, BARTLETT, TN 38134-2875
(901) 377-1744
(901) 507-4772
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DS0000007616
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3205648
—
TN
Enumeration date
04/15/2008
Last updated
04/15/2008
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