Organization
S. ADAM TACKETT, DMD, MS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHEN ADAM TACKETT DMD, MS (ORTHODONTIST)
(606) 523-2000
Entity
Organization
Contact information
Practice address
727 W CUMBERLAND GAP PKWY STE D, CORBIN, KY 40701-5194
(606) 523-2000
Mailing address
727 W CUMBERLAND GAP PKWY STE D, CORBIN, KY 40701-5194
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
02/01/2019
Last updated
02/01/2019
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