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Individual

BETHANY K TANT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
3160 HENDERSON DR, JACKSONVILLE, NC 28546-5248
(910) 346-5600
(910) 346-5396
Mailing address
3160 HENDERSON DR, JACKSONVILLE, NC 28546-5248
(910) 346-5600
(910) 346-5396

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7813
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2060755
UCCI
NC
05
5908945
NC
Enumeration date
01/17/2006
Last updated
07/02/2015
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