Provider Demographics
NPI:1639210230
Name:THE DENTAL OFFICE AT SADDLE CREEK
Entity type:Organization
Organization Name:THE DENTAL OFFICE AT SADDLE CREEK
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MGR.
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:GUILFORD
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:III
Authorized Official - Credentials:MHA
Authorized Official - Phone:901-754-4200
Mailing Address - Street 1:7535 POPLAR AVE
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38138-3812
Mailing Address - Country:US
Mailing Address - Phone:901-754-4200
Mailing Address - Fax:901-754-5309
Practice Address - Street 1:7535 POPLAR AVE
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138-3812
Practice Address - Country:US
Practice Address - Phone:901-754-4200
Practice Address - Fax:901-754-5309
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Not Answered1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty