Organization
TAILWATER PRACTICE PARTNERS
Active
Parent organization
TAILWATER PRACTICE PARTNERS
Other names
Moore Dental Office
Organization subpart
Yes
Provider details
NPI number
Legal business name
TAILWATER PRACTICE PARTNERS
Authorized official
ANGIE LOFT (RCM DIRECTOR)
(651) 303-3203
Entity
Organization
Contact information
Practice address
113 KENNEDY DR, MARTIN, TN 38237-3344
(731) 587-4742
Mailing address
113 KENNEDY DR, MARTIN, TN 38237-3344
(731) 587-4742
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
08/01/2024
Last updated
08/01/2024
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