Individual
DR. BRIAN PAUL TATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MSD
Contact information
Practice address
112 E ALTO RD, KOKOMO, IN 46902-3601
(765) 455-2505
(765) 455-2564
Mailing address
112 E ALTO RD, KOKOMO, IN 46902-3601
(765) 455-2505
(765) 455-2564
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
12009788
IN
Other
Enumeration date
09/22/2006
Last updated
07/08/2007
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