| Collierville Dental Associates | |
|
624 W Poplar Ave Collierville TN 38017-2540 | |
| (901) 853-2520 | |
| (901) 854-9273 |
| Full Name | Collierville Dental Associates |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 624 W Poplar Ave, Collierville, Tennessee |
| Authorized Official Name and Position | Charles Edmund Young (OWNER) |
| Authorized Official Contact | 9018532520 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Collierville Dental Associates 624 W Poplar Ave Collierville TN 38017-2540 Ph: (901) 853-2520 | Collierville Dental Associates 624 W Poplar Ave Collierville TN 38017-2540 Ph: (901) 853-2520 |
| NPI Number | 1285703884 |
|---|---|
| Provider Enumeration Date | 11/07/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285703884 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DS0000002304 (Tennessee) | Primary |
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