Provider Demographics
NPI:1629702451
Name:DENNING, ANDREW MCCORMACK (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:MCCORMACK
Last Name:DENNING
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 1:1617 FAXON AVE
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38112-4920
Mailing Address - Country:US
Mailing Address - Phone:404-790-4224
Mailing Address - Fax:
Practice Address - Street 1:6888 GOODMAN RD STE 123
Practice Address - Street 2:
Practice Address - City:OLIVE BRANCH
Practice Address - State:MS
Practice Address - Zip Code:38654-8761
Practice Address - Country:US
Practice Address - Phone:662-268-6539
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-16
Last Update Date:2022-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN12004122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist