Provider Demographics
NPI:1073601753
Name:GAITHER, SILAS DWAIN (DDS PC)
Entity Type:Individual
Prefix:DR
First Name:SILAS
Middle Name:DWAIN
Last Name:GAITHER
Suffix:
Gender:M
Credentials:DDS PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6425 QUAIL HOLLOW ROAD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38120
Mailing Address - Country:US
Mailing Address - Phone:901-767-3020
Mailing Address - Fax:901-767-3041
Practice Address - Street 1:6425 QUAIL HOLLOW ROAD
Practice Address - Street 2:SUITE 102
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38120
Practice Address - Country:US
Practice Address - Phone:901-767-3020
Practice Address - Fax:901-767-3041
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS2227122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist