Tate Family Dentistry, Pa

NPI 1003811100 - Dentist - 1223G0001X

NPI Details
NPI 1003811100
Enumeration Date 06/15/2005
Last Updated 12/15/2014
Entity Type Healthcare Provider
Active Over 11 years ago
Authorized Information
Name JOHN TYLER JOHN
Position SECRETARY
Phone (817) 481-6364
Fax (817) 329-2296
Practice Location
3101 E STATE HIGHWAY 114
STE A
SOUTHLAKE TX, 76092-6690, US
Phone (817) 481-6364
Fax (817) 329-2296
Business Location
3101 E STATE HIGHWAY 114
STE A
SOUTHLAKE TX, 76092-6690, US
Phone (817) 481-6364
Fax (817) 329-2296
Toxanomy
Taxonomy Code 1223G0001X
License State Texas
License Number TX11540
Remove 1003811100 NPI Number
 

According to our database, Tate Family Dentistry, Pa NPI is 1003811100, taxonomy code is 1223G0001X and license number is TX11540, license state is located at Texas. Tate Family Dentistry, Pa physically located at 3101 E State Highway 114, Southlake TX, 76092-6690. NPI Number 1033115704 has the healthcare provider type.

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1003811100 NPI number is provided on an as is basis without warranty of any kind. 1003811100 is maintained by the National Plan & Provider Enumeration System. The contents of Tate Family Dentistry, Pa are for informational purposes only.