| Dr Mitchell Scott Tatum, DDS, | |
|
201 S 3rd St, Smithville, TN 37166-1712 | |
| (615) 597-4798 | |
| (615) 597-3171 |
| Full Name | Dr Mitchell Scott Tatum |
|---|---|
| Gender | Male |
| Speciality | Dentist |
| Location | 201 S 3rd St, Smithville, Tennessee |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831296425 | NPI | - | NPPES |
| 3142596 | Other | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DS 7129 (Tennessee) | Primary |
| Entity Name | Dekalb Dental Center Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1700452026 PECOS PAC ID: 5294135067 Enrollment ID: O20210616000177 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Mitchell Scott Tatum, DDS, 201 S 3rd St, Smithville, TN 37166-1712 Ph: (615) 597-4798 | Dr Mitchell Scott Tatum, DDS, 201 S 3rd St, Smithville, TN 37166-1712 Ph: (615) 597-4798 |
Dr. Daniel Jefferson Barnes, DDS Dentist Medicare: Medicare Enrolled Practice Location: 407 South Mt Street, Smithville, TN 37166 Phone: 615-597-1110 Fax: 615-597-9537 | |
Dr. Alexander Hayes, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 201 S 3rd St, Smithville, TN 37166 Phone: 615-587-6632 | |
Dr. Clifford Grant Duke, D.D.S. Dentist Medicare: Medicare Enrolled Practice Location: 612 S Congress Blvd, Smithville, TN 37166 Phone: 615-597-7788 Fax: 615-597-4737 |