Provider Demographics
NPI:1265414148
Name:MCLEMORE, JOHN HERRON (DDS)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:HERRON
Last Name:MCLEMORE
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 1:72 MIMOSA DR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38301-4257
Mailing Address - Country:US
Mailing Address - Phone:731-427-6838
Mailing Address - Fax:
Practice Address - Street 1:211 OILWELL RD
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38305
Practice Address - Country:US
Practice Address - Phone:731-424-2651
Practice Address - Fax:731-424-2653
Is Sole Proprietor?:No
Enumeration Date:2005-11-16
Last Update Date:2007-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS00000077731223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice