Individual
DR. DIANA TINA DO MAYO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
3130 TOM AUSTIN HWY STE B, SPRINGFIELD, TN 37172-4579
(615) 382-9005
Mailing address
3130 TOM AUSTIN HWY STE B, SPRINGFIELD, TN 37172-4579
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
11677
CT
1223P0221X
Pediatric Dentistry
Primary
12055
TN
1223P0221X
Pediatric Dentistry
2874
HI
1223P0221X
Pediatric Dentistry
32478
TX
1223P0221X
Pediatric Dentistry
98
HI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
830465
—
HI
Enumeration date
04/29/2015
Last updated
12/17/2024
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