Individual
DR. JULIE C TANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
1121 JOHNSON FERRY RD, SUITE 450, MARIETTA, GA 30068-5425
(770) 973-8911
(770) 509-7403
Mailing address
1000 JOHNSON FERRY RD, SUITE A-100, MARIETTA, GA 30068-2114
(770) 973-8911
(770) 509-7403
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN012372
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1871719773
PRACTICE GROUP NPI
—
01
—
20-3998771
GROUP FEDERAL ID #
—
Enumeration date
03/27/2013
Last updated
10/24/2014
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