# TATUM POINT DENTISTRY LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255946257
- **Authorized official:** KRISTINA KELLICI (MANAGER)
- **Authorized official phone:** (623) 439-2280

## Contact information

- **Practice address:** 4747 E BELL RD, STE \#15, PHOENIX, AZ 85032-2301
- **Practice address phone:** (623) 289-2580
- **Mailing address:** TATUM POINT DENTISTRY LLC, 19601 N BLACK CANYON HWY, \#201, PHOENIX, AZ 85027-4107
- **Mailing address phone:** (623) 289-2580
- **Mailing address fax:** (623) 289-2015

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |
| 261QD0000X | Dental Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 09/15/2020
- **Last updated:** 08/30/2024