Individual
TANNER JAMESON MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3105 MIDDLE DR STE A, COLUMBUS, IN 47203-4472
(317) 656-0709
(812) 379-1977
Mailing address
3105 MIDDLE DR STE A, COLUMBUS, IN 47203-4472
(317) 656-0709
(812) 379-1977
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12013213A
IN
Other
Enumeration date
10/15/2019
Last updated
10/15/2019
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