Provider Demographics
NPI:1174508204
Name:MCLEMORE, JAMES PETER III (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:PETER
Last Name:MCLEMORE
Suffix:III
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 OILWELL RD
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38305
Mailing Address - Country:US
Mailing Address - Phone:731-424-2651
Mailing Address - Fax:731-424-2653
Practice Address - Street 1:211 OILWELL RD
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38305
Practice Address - Country:US
Practice Address - Phone:731-424-2651
Practice Address - Fax:731-424-2653
Is Sole Proprietor?:No
Enumeration Date:2005-12-13
Last Update Date:2007-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0042431223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN004243OtherSTATE LICENSE NUMBER