Organization
MARILIA P. TATE, DMD,PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARILIA P. TATE DMD (OWNER/PRESIDENT)
(205) 979-9491
Entity
Organization
Contact information
Practice address
2030 PATTON CHAPEL RD, BIRMINGHAM, AL 35216-5770
(205) 979-9491
Mailing address
2030 PATTON CHAPEL RD, BIRMINGHAM, AL 35216-5770
(205) 979-9491
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5939
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
511-45494
BLUE CROSS BLUE SHIELD OF AL
AL
Enumeration date
01/05/2015
Last updated
01/05/2015
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