Organization
ORAL & MAXILLOFACIAL SURGERY CLINIC INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ISAAC FORDJOUR DDS (PRESIDENT)
(901) 526-3988
Entity
Organization
Contact information
Practice address
910 MADISON AVE STE 710, MEMPHIS, TN 38103-3453
(901) 526-3988
(901) 526-9807
Mailing address
910 MADISON AVE STE 710, MEMPHIS, TN 38103-3453
(901) 526-3988
(901) 526-9807
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
01/29/2014
Last updated
01/29/2014
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