Provider First Line Business Practice Location Address:
875 UNION AVE DUNN DENTAL BLDG C 517
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MEMPHIS
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
38163
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
901-448-1848
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/01/2018