Edp of Tennessee PC

NPI #1780143800 in Germantown, Tennessee

Provider Information

NPI Number
1780143800
Entity Type
Organization
Organization Name
Edp of Tennessee PC
Subpart
Yes (part of a larger organization)
Parent Organization
EDP OF TENNESSEE PC
Primary Specialty
Clinic/Center - Dental
Enumeration Date
Mar 18, 2019
Last Updated
Sep 16, 2019

Practice Location

Address
7938 WOLF RIVER BLVD
ZIP Code
38138-1725
Phone
(901) 754-3117

Authorized Official

Name
ROSEANNE BRUNENKANT
Title
DIRECTOR OF INTEGRATIONS
Phone
(312) 937-3619

Specialties & Taxonomy Codes

Specialty
Clinic/Center - DentalDental

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