Organization
TUN TAVERN, LLC
Active
Other names
Montee Tailored Smiles
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STAN A MONTEE DMD (OWNER)
(931) 220-9469
Entity
Organization
Contact information
Practice address
16 S CENTRAL AVE, MONTEAGLE, TN 37356-3075
(931) 220-9469
Mailing address
222 GREENBRIAR DR, TULLAHOMA, TN 37388-8008
(931) 220-9469
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1760436729
FEDERAL NPI NUMBER
—
Enumeration date
05/05/2022
Last updated
05/05/2022
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