Tate Family Dentistry, PA

NPI #1003811100 in Southlake, Texas

Provider Information

NPI Number: 1003811100
Entity Type: Organization
Organization Name: Tate Family Dentistry, PA
Primary Specialty: Dentist - General Practice
Enumeration Date: Jun 15, 2005
Last Updated: Dec 15, 2014

Practice Location

Address: 3101 E STATE HIGHWAY 114
Address 2: STE A
City: Southlake
State: Texas
ZIP Code: 76092-6690
Phone: (817) 481-6364

Authorized Official

Name: DR. JOHN TYLER TATE, D.D.S.
Title: SECRETARY
Phone: (817) 481-6364

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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