Individual
CHARLES JEFFREY TANNEBRING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
22 BROADWAY, BEVERLY, MA 01915-4435
(978) 922-0105
Mailing address
22 BROADWAY, BEVERLY, MA 01915-4435
(978) 922-0105
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
013710
MA
Other
Enumeration date
05/27/2006
Last updated
07/08/2007
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