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Individual

DR. HARRY E TATOIAN JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.M.D.

Contact information

Practice address
3716 MELROSE AVE NW, ROANOKE, VA 24017-2716
(540) 362-0360
Mailing address
PO BOX 3475, PAWLEYS ISLAND, SC 29585-3475
(781) 964-1233

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401414742
VA
1223G0001X
General Practice Dentistry
11936
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00000179289
UNITED CONCORDIA
MA
05
0271071
MA
Enumeration date
03/08/2007
Last updated
08/15/2019
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