Dr. Mary Victoria Tatum, DMD
Dentist, General Practice in Charleston, SC. Individual provider (NPI-1).
NPI number1003033192
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1003033192
- Entity type
- Individual (NPI-1)
- Name
- Dr. Mary Victoria Tatum
- Credential
- DMD
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Apr 19, 2007
- Last updated
- Jul 8, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | 3084 | SC | Yes |
Practice location
92 Courtenay DrCharleston, SC 29403-5742
Phone 843-577-6112 · Fax 843-937-0200
Mailing address
92 Courtenay DrCharleston, SC 29403-5742
Phone 843-577-6112 · Fax 843-937-0200
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