Individual
MICHAEL ELLIS TULLOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RDH
Contact information
Practice address
435 NEW BYHALIA RD, COLLIERVILLE, TN 38017-3747
(901) 612-2477
Mailing address
1003 BRUCE ST, MEMPHIS, TN 38104-5807
(662) 836-7483
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
7517
TN
Other
Enumeration date
02/19/2019
Last updated
02/19/2019
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