Provider Demographics
NPI:1366500977
Name:LEVY, LAYNE C (DDS)
Entity Type:Individual
Prefix:DR
First Name:LAYNE
Middle Name:C
Last Name:LEVY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4688 AMERICAN WAY
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38118-8404
Mailing Address - Country:US
Mailing Address - Phone:901-362-7232
Mailing Address - Fax:901-362-2372
Practice Address - Street 1:4688 AMERICAN WAY
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38118-8404
Practice Address - Country:US
Practice Address - Phone:901-362-7232
Practice Address - Fax:901-362-2372
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS005188122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist