Organization
CORDOVA DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACEY FULK (RECEPTIONIST)
(901) 759-0999
Entity
Organization
Contact information
Practice address
8333 CORDOVA RD, CORDOVA, TN 38016-2046
(901) 759-0999
(901) 758-8777
Mailing address
8333 CORDOVA RD, CORDOVA, TN 38016-2046
(901) 759-0999
(901) 758-8777
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
06/24/2011
Last updated
06/24/2011
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