Provider Demographics
NPI:1467562314
Name:DENTAL EXCELLENCE PC
Entity Type:Organization
Organization Name:DENTAL EXCELLENCE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:LINDSEY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:901-685-1152
Mailing Address - Street 1:5180 PARK AVE STE 310
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38119-3531
Mailing Address - Country:US
Mailing Address - Phone:901-685-1152
Mailing Address - Fax:901-682-6846
Practice Address - Street 1:5180 PARK AVE STE 310
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38119-3531
Practice Address - Country:US
Practice Address - Phone:901-685-1152
Practice Address - Fax:901-682-6846
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2013-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN39191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty