Whalio Doctors

NPI 1053495697

New Image Family Dentistry R

Organisation Non-Pharmacy Dispensing Site Memphis, TN

Practice location

Address
3719 Riverdale Rd, Memphis, TN 38115-5322
Phone
(901) 365-2000
Fax
(901) 365-2626

Authorised official

Name
Direndia Shackelford
Title
Managed Care Specialist
Phone
(800) 654-0889

Registered specialties

Non-Pharmacy Dispensing Site Primary
Suppliers Taxonomy 332900000X Licence DS0000006961 (TN)

Registry record

NPI
1053495697
Entity type
Organization
NPI issued
24 Oct 2006
Record last updated
22 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.