Provider Demographics
NPI:1477621837
Name:STURGIS, DIERDRE D (DDS)
Entity Type:Individual
Prefix:DR
First Name:DIERDRE
Middle Name:D
Last Name:STURGIS
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 1:3515 WINDGARDEN CV
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38125-1733
Mailing Address - Country:US
Mailing Address - Phone:901-683-6770
Mailing Address - Fax:901-737-4499
Practice Address - Street 1:5180 PARK AVE
Practice Address - Street 2:SUITE 260
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38119-3521
Practice Address - Country:US
Practice Address - Phone:901-683-6770
Practice Address - Fax:901-766-1640
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS72001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice