Provider Demographics
NPI:1376669549
Name:DOAN, H CANNON (DDS)
Entity Type:Individual
Prefix:DR
First Name:H
Middle Name:CANNON
Last Name:DOAN
Suffix:
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 1:8135 WALNUT GROVE RD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38018-4240
Mailing Address - Country:US
Mailing Address - Phone:901-755-3626
Mailing Address - Fax:901-755-7870
Practice Address - Street 1:8135 WALNUT GROVE RD
Practice Address - Street 2:SUITE 4
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38018-4240
Practice Address - Country:US
Practice Address - Phone:901-755-3626
Practice Address - Fax:901-755-7870
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN43791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice