Organization
AMERICAN FAMILY DENTISTRY OF MEMPHIS, PC
Active
Parent organization
AMERICAN FAMILY DENTISTRY OF MEMPHIS, PC
Other names
American Family Dentistry Olive Branch
Organization subpart
Yes
Provider details
NPI number
Legal business name
AMERICAN FAMILY DENTISTRY OF MEMPHIS, PC
Authorized official
CELIA HAYES (CREDENTIALING COORDINATOR)
(217) 540-2100
Entity
Organization
Contact information
Practice address
5218 GOODMAN RD STE 109, OLIVE BRANCH, MS 38654-7985
(662) 892-3633
(662) 892-3611
Mailing address
5218 GOODMAN RD STE 109, OLIVE BRANCH, MS 38654-7985
(662) 892-3633
(662) 892-3611
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
01/04/2022
Last updated
01/04/2022
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