Provider Demographics
NPI:1780887364
Name:FINK, TERENCE MARTIN (DDS)
Entity type:Individual
Prefix:DR
First Name:TERENCE
Middle Name:MARTIN
Last Name:FINK
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 1:2761 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38111-1812
Mailing Address - Country:US
Mailing Address - Phone:901-323-2979
Mailing Address - Fax:
Practice Address - Street 1:110 GUTHRIE DR
Practice Address - Street 2:
Practice Address - City:SOUTHAVEN
Practice Address - State:MS
Practice Address - Zip Code:38671-5828
Practice Address - Country:US
Practice Address - Phone:662-393-7830
Practice Address - Fax:662-393-7387
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS2701-92-D1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice