Organization
TUCKER & GAILIS DENTAL , LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THERESA K TUCKER DDS (DOCTOR/ OWNER)
(541) 884-9555
Entity
Organization
Contact information
Practice address
2586 CLOVER ST, KLAMATH FALLS, OR 97601-1115
(541) 884-9555
(541) 882-7423
Mailing address
2586 CLOVER ST, KLAMATH FALLS, OR 97601-1115
(541) 884-9555
(541) 882-7423
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
15-000001304
OR
Other
Enumeration date
06/11/2015
Last updated
06/11/2015
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