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Individual

DR. JOHN WADE TUCKER JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
4129 SOUTH FIRST ST, MILAN, TN 38358
(731) 686-3956
(731) 723-4067
Mailing address
PO BOX 506, 4129 SOUTH FIRST STREET, MILAN, TN 38358
(731) 686-3956
(731) 723-4067

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
TN4052
TN

Other

Enumeration date
06/29/2006
Last updated
07/08/2007
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