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Organization

BARTLETT PEDIATRIC DENTISTRY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. WENDI STUHR CDA, RDA (OFFICE MANAGER)
(901) 382-1564
Entity
Organization

Contact information

Practice address
3071 KIRBY WHITTEN RD, BARTLETT, TN 38134-2822
(901) 382-1564
(901) 382-0657
Mailing address
3071 KIRBY WHITTEN RD, BARTLETT, TN 38134-2822
(901) 382-1564
(901) 382-0657

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DS2722
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0100184
BLUE CROSS BLUE SHIELD
TN
Enumeration date
03/19/2007
Last updated
12/13/2007
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