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Individual

DR. NATHAN M TANNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
725 N 5TH ST STE 101, JACKSONVILLE, OR 97530
(541) 862-1848
(541) 474-5005
Mailing address
2288 WILLIAMS HWY, GRANTS PASS, OR 97527
(541) 862-1848
(541) 474-5005

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D8947
OR

Other

Enumeration date
08/05/2007
Last updated
03/29/2016
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