Organization
KATHERINE A. DECOLIBUS, DDS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHERINE DECOLIBUS (OWNER)
(901) 680-0377
Entity
Organization
Contact information
Practice address
4132 POPLAR AVE, MEMPHIS, TN 38117-3618
(901) 680-0377
(901) 680-0377
Mailing address
4132 POPLAR AVE, MEMPHIS, TN 38117-3618
(901) 680-0377
(901) 680-0377
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7389
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
214726
—
TN
Enumeration date
04/04/2008
Last updated
04/04/2008
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