Organization
FRED WESBERRY DENTISTRY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID M KIMLER DDS (OWNER)
(901) 362-9995
Entity
Organization
Contact information
Practice address
716 W BROOKHAVEN CIR, MEMPHIS, TN 38117-4504
(901) 844-1590
(901) 844-1592
Mailing address
2900 S PERKINS RD, MEMPHIS, TN 38118-3237
(901) 362-9995
(901) 362-9989
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
000000051
TN
Other
Enumeration date
04/10/2012
Last updated
04/10/2012
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