Organization
PREMIUM CARE DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOE D O'NEAL DDS (OWNER)
(901) 730-1321
Entity
Organization
Contact information
Practice address
1331 UNION AVE STE 1240, MEMPHIS, TN 38104-7552
(901) 730-1321
(901) 730-1382
Mailing address
1331 UNION AVENUE #1240, MEMPHIS, TN 38104-7551
(901) 730-1321
(901) 730-1382
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3438
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3225297
—
TN
Enumeration date
11/25/2015
Last updated
11/25/2015
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