Individual
MOHAMAD ELASSOULI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1022 N GERMANTOWN PKWY, CORDOVA, TN 38018-5892
(901) 201-5662
Mailing address
1022 N GERMANTOWN PKWY, CORDOVA, TN 38018-5892
(901) 201-5662
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4135-20
MS
Other
Enumeration date
07/14/2020
Last updated
01/05/2024
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