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Individual

BRIAN W. TALLENT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
3111 SPRINGBANK LN., SUITE A, CHARLOTTE, NC 28226
(704) 541-3603
(704) 541-3619
Mailing address
3111 SPRINGBANK LN., SUITE A, CHARLOTTE, NC 28226
(704) 541-3603
(704) 541-3619

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
9535
NC
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
04/14/2009
Last updated
09/20/2018
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