Individual
DR. KAHALA C CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
5366 MENDENHALL MALL, MEMPHIS, TN 38115-4505
(901) 271-6156
(901) 271-6195
Mailing address
2595 CENTRAL AVE, MEMPHIS, TN 38104-5905
(901) 271-6300
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8044
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3497809
—
TN
Enumeration date
10/26/2005
Last updated
09/27/2013
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