Organization
MID-SOUTH TMJ AND SLEEP APNEA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALAN O BLANTON DDS (OWNER)
(901) 417-0888
Entity
Organization
Contact information
Practice address
362 NEW BYHALIA RD STE 3, COLLIERVILLE, TN 38017-3731
(901) 468-7088
(901) 221-2280
Mailing address
1850 KIMBROUGH RD, GERMANTOWN, TN 38138-3282
(901) 417-0888
Taxonomy
Speciality
Code
Description
License number
State
1223X2210X
Orofacial Pain Dentistry
Primary
—
—
261QP3300X
Pain Clinic/Center
—
—
332BC3200X
Customized Equipment (DME)
—
—
Other
Enumeration date
12/12/2022
Last updated
10/18/2023
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