Individual
DR. JON CARL STANFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
3596 PARK AVE, MEMPHIS, TN 38111-5622
(901) 458-2617
Mailing address
3596 PARK AVE, MEMPHIS, TN 38111-5622
(901) 458-2617
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS003629
TN
Other
Enumeration date
11/01/2006
Last updated
10/23/2014
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