Individual
SHAUNA TANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
303 BANCARIO, STE #11-12, MARION, AR 72364-2825
(870) 739-2992
Mailing address
9298 POSITANO LN, GERMANTOWN, TN 38138-7393
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
9156
TN
1223P0221X
Pediatric Dentistry
3951
AR
Other
Enumeration date
06/22/2010
Last updated
09/03/2013
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