Individual
DR. TIMOTHY NATHANIEL TATE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
910 BERT KOUNS INDUSTRIAL LOOP, SHREVEPORT, LA 71118-3410
(318) 686-7470
Mailing address
5100 MARIGNY ST, NEW ORLEANS, LA 70122-5118
(504) 909-7434
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6678
LA
Other
Enumeration date
06/09/2016
Last updated
06/09/2016
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