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Individual

WAYNE D. LICHLITER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
2176 WEST ST, SUITE 302, GERMANTOWN, TN 38138-3829
(901) 754-2967
(901) 755-2422
Mailing address
2176 WEST ST, SUITE 302, GERMANTOWN, TN 38138-3829
(901) 754-2967
(901) 755-2422

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3597
TN

Other

Enumeration date
12/28/2006
Last updated
07/08/2007
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