Tailwater Practice Partners

NPI #1457180838 in Martin, Tennessee

Provider Information

NPI Number: 1457180838
Entity Type: Organization
Organization Name: Tailwater Practice Partners
Subpart: Yes (part of a larger organization)
Parent Organization: TAILWATER PRACTICE PARTNERS
Primary Specialty: Dentist
Enumeration Date: Aug 1, 2024
Last Updated: Aug 1, 2024

Practice Location

Address: 113 KENNEDY DR
City: Martin
State: Tennessee
ZIP Code: 38237-3344
Phone: (731) 587-4742

Authorized Official

Name: ANGIE LOFT
Title: RCM DIRECTOR
Phone: (651) 303-3203

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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