Provider Demographics
NPI:1043994098
Name:HIGH POINT DENTAL
Entity Type:Organization
Organization Name:HIGH POINT DENTAL
Other - Org Name:THE GREENLINE DENTIST
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAIGE
Authorized Official - Middle Name:
Authorized Official - Last Name:GASSMANN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:901-254-8022
Mailing Address - Street 1:3689 HIGHLAND PARK PL
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38111-6133
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:473 HIGH POINT TER STE A
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38122-4621
Practice Address - Country:US
Practice Address - Phone:901-323-4695
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-12
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental