Individual
DR. GEORGE WALLACE TATE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
ROCKY BOY HEALTH BOARD, RR 1 BOX 664, BOX ELDER, MT 59521-9797
(406) 395-4486
(406) 395-5850
Mailing address
RR 1 BOX 664, ROCKY BOY HEALTH BOARD, BOX ELDER, MT 59521-9797
(406) 395-4486
(406) 395-5850
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
LA2383
LA
Other
Enumeration date
07/03/2007
Last updated
09/19/2007
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