| Pickwick Family Dental | |
|
7730 Wolf River Blvd Suite 104 Germantown TN 38138-1708 | |
| (601) 755-6440 | |
| (901) 755-6436 |
| Full Name | Pickwick Family Dental |
|---|---|
| Speciality | Dentist |
| Location | 7730 Wolf River Blvd, Germantown, Tennessee |
| Authorized Official Name and Position | Donald Gavin Walley (PRESIDENT) |
| Authorized Official Contact | 9017556440 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pickwick Family Dental 7730 Wolf River Blvd Suite 104 Germantown TN 38138-1708 Ph: (601) 755-6440 | Pickwick Family Dental 7730 Wolf River Blvd Suite 104 Germantown TN 38138-1708 Ph: (601) 755-6440 |
| NPI Number | 1215108923 |
|---|---|
| Provider Enumeration Date | 03/20/2008 |
| Last Update Date | 03/04/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215108923 | NPI | - | NPPES |
| 4742 | Medicaid | TN | |
| 9200300 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DS0000004635 (Tennessee) | Secondary |
| 122300000X | Dentist | DS00000004675 (Tennessee) | Primary |
Whittemore-gruen, Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2165 West St, Germantown, TN 38138 Phone: 901-754-0540 Fax: 901-754-0621 | |
Audubon Dental Group Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2059 S Houston Levee Rd, Suite 126, Germantown, TN 38139 Phone: 901-853-9800 | |
Elite Dental Germantown Plc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 9064 Corporate Gradens Drive, Germantown, TN 38138 Phone: 731-855-1053 Fax: 731-855-8064 | |
Purfixsmile Dental, Inc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 9245 Poplar Ave, 8-161, Germantown, TN 38138 Phone: 901-414-0350 | |
Graves Family Dentistry Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 7503 Queens Court, Suite 3, Germantown, TN 38138 Phone: 901-754-9248 Fax: 901-737-3778 | |
Purfixsmile Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 9245 Poplar Ave, Suite 8-161, Germantown, TN 38138 Phone: 901-414-0350 |