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Organization

UNIVERSITY OF TENNESSEE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BERNELL A ROGERS (ACCOUNTING ASSISTANT LLL)
(901) 448-4944
Entity
Organization

Contact information

Practice address
875 UNION AVE RM S219, MEMPHIS, TN 38163-0001
(901) 448-4944
(901) 448-7104
Mailing address
875 UNION AVE RM S219, MEMPHIS, TN 38163-0001
(901) 448-4944
(901) 448-7104

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary

Other

Enumeration date
11/24/2006
Last updated
08/22/2020
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