Provider Demographics
NPI:1558472134
Name:GARRETT, FLOYD A (DDS)
Entity Type:Individual
Prefix:
First Name:FLOYD
Middle Name:A
Last Name:GARRETT
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 1:8089 WALNUT RUN RD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38018-8843
Mailing Address - Country:US
Mailing Address - Phone:901-737-8981
Mailing Address - Fax:
Practice Address - Street 1:8089 WALNUT RUN RD
Practice Address - Street 2:SUITE 3
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38018-8843
Practice Address - Country:US
Practice Address - Phone:901-737-8981
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN73811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice