Provider Demographics
NPI:1194706697
Name:FRIZZELL, JEFFREY POPE (DDS)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:POPE
Last Name:FRIZZELL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:785 ESTATE PL 2
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38120-0639
Mailing Address - Country:US
Mailing Address - Phone:901-766-9002
Mailing Address - Fax:901-766-9031
Practice Address - Street 1:4177 MACON RD
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38122-2413
Practice Address - Country:US
Practice Address - Phone:901-454-6103
Practice Address - Fax:901-454-6103
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-10
Last Update Date:2015-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS3929122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist