Organization
SHELBY DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHELBY DENE BLAYLOCK DDS (DENTIST/OWNER)
(901) 767-2290
Entity
Organization
Contact information
Practice address
990 JUNE RD, MEMPHIS, TN 38119-3702
(901) 767-2290
(901) 683-4524
Mailing address
990 JUNE RD, MEMPHIS, TN 38119-3702
(901) 767-2290
(901) 683-4524
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
10/31/2018
Last updated
10/31/2018
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