Provider Demographics
NPI:1699816223
Name:RALEIGH FAMILY DENTISTRY
Entity Type:Organization
Organization Name:RALEIGH FAMILY DENTISTRY
Other - Org Name:AMERICAN FAMILY DENTISTRY
Other - Org Type:Other Name
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:D
Authorized Official - Last Name:CURRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-386-2328
Mailing Address - Street 1:3068 COVINGTON PIKE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38128-5001
Mailing Address - Country:US
Mailing Address - Phone:901-386-2328
Mailing Address - Fax:901-382-1538
Practice Address - Street 1:3068 COVINGTON PIKE
Practice Address - Street 2:SUITE 2
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38128-5001
Practice Address - Country:US
Practice Address - Phone:901-386-2328
Practice Address - Fax:901-382-1538
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2008-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN45323381223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty