Individual
DR. MICHAEL DALE SHIRLEY
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
4302 SUMMER AVE, MEMPHIS, TN 38122-4000
(901) 683-3849
(901) 685-7734
Mailing address
4302 SUMMER AVE, MEMPHIS, TN 38122-4000
(901) 683-3849
(901) 685-7734
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS0000005139
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0160274
BLUE CROSS BLUE SHIELD
TN
Enumeration date
11/30/2005
Last updated
07/08/2007
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