Organization
CENTER FOR ORAL AND FACIAL SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JESSICA R. FORTNER (ADMINISTRATIVE ASSISSTANT)
(901) 398-0793
Entity
Organization
Contact information
Practice address
1251 WESLEY DR, SUITE 101, MEMPHIS, TN 38116-6442
(901) 398-0793
(901) 398-0222
Mailing address
1251 WESLEY DR, SUITE 101, MEMPHIS, TN 38116-6442
(901) 398-0793
(901) 398-0222
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
03/18/2008
Last updated
03/18/2008
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