| Park Station Dental Group | |
|
5180 Park Ave Suite 310 Memphis TN 38119-3521 | |
| (901) 685-1152 | |
| (901) 682-6846 |
| Full Name | Park Station Dental Group |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 5180 Park Ave, Memphis, Tennessee |
| Authorized Official Name and Position | Milton Siskin (OWNER / DENTIST) |
| Authorized Official Contact | 9016851152 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Park Station Dental Group 5180 Park Ave Suite 310 Memphis TN 38119-3521 Ph: (901) 685-1152 | Park Station Dental Group 5180 Park Ave Suite 310 Memphis TN 38119-3521 Ph: (901) 685-1152 |
| NPI Number | 1407094121 |
|---|---|
| Provider Enumeration Date | 02/03/2009 |
| Last Update Date | 02/03/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407094121 | NPI | - | NPPES |
| 4031894 | Other | TN | BLUE CROSS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 4206 (Tennessee) | Primary |
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