Organization
PRESTIGE DENTAL DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KURT HOLMES DDS (OWNER/DENTIST)
(901) 619-0347
Entity
Organization
Contact information
Practice address
3267 HACKS CROSS ROAD, MEMPHIS, TN 38125-2367
(901) 619-0347
Mailing address
3750 HACKS CROSS RD, SUITE 102-206, MEMPHIS, TN 38125-2367
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7908
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1275602716
INDIVIDUAL NPI
—
Enumeration date
12/01/2015
Last updated
03/25/2016
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