# DEKALB DENTAL CENTER PLLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** DEKALB DENTAL CENTER PLLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1700452026
- **Legal business name:** DEKALB DENTAL CENTER PLLC
- **Authorized official:** MITCHELL SCOTT TATUM DDS (OWNER)
- **Authorized official phone:** (615) 597-4798

## Contact information

- **Practice address:** 201 S 3RD ST, SMITHVILLE, TN 37166-1712
- **Practice address phone:** (615) 597-4798
- **Mailing address:** 201 S 3RD ST, SMITHVILLE, TN 37166-1712
- **Mailing address phone:** (615) 597-4798

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 05/27/2021
- **Last updated:** 05/27/2021