Organization
TENNESSEE DENTAL PROFESSIONALS PC
Active
Parent organization
TENNESSEE DENTAL PROFESSIONALS PC
Other names
Great Southern Smiles
Organization subpart
Yes
Provider details
NPI number
Legal business name
TENNESSEE DENTAL PROFESSIONALS PC
Authorized official
BELINDA HUERTA (CREDENTIALING COORDINATOR)
(217) 540-2100
Entity
Organization
Contact information
Practice address
9407 POPLAR AVE, GERMANTOWN, TN 38138-8003
(901) 309-6821
Mailing address
9407 POPLAR AVE, GERMANTOWN, TN 38138-8003
(901) 309-6821
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
10/08/2014
Last updated
03/15/2023
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