Provider Demographics
NPI:1841725843
Name:DENTALCARES
Entity type:Organization
Organization Name:DENTALCARES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:901-753-2273
Mailing Address - Street 1:1890 N GERMANTOWN PKWY STE 105
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38016-3325
Mailing Address - Country:US
Mailing Address - Phone:901-753-2273
Mailing Address - Fax:901-753-7673
Practice Address - Street 1:1890 N GERMANTOWN PKWY STE 105
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38016-3325
Practice Address - Country:US
Practice Address - Phone:901-753-2273
Practice Address - Fax:901-753-7673
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-27
Last Update Date:2017-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS0000005177122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty