Organization
WOLF RIVER DENTAL CENTER PLLC
Active
Other names
Wolf River Dental Center PLLC
Organization subpart
No
Provider details
NPI number
Authorized official
MAX S BREAZEAL DDS (OWNER)
(901) 491-4859
Entity
Organization
Contact information
Practice address
280 GERMAN OAK DR, CORDOVA, TN 38018-7220
(901) 522-6640
Mailing address
61 PEYTON PKWY STE 103, COLLIERVILLE, TN 38017-9702
(901) 491-4859
(901) 861-4031
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
11/20/2018
Last updated
11/20/2018
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