| Tun Tavern, Llc | |
|
16 S Central Ave Monteagle TN 37356-3075 | |
| (931) 220-9469 | |
| Not Available |
| Full Name | Tun Tavern, Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 16 S Central Ave, Monteagle, Tennessee |
| Authorized Official Name and Position | Stan A Montee (OWNER) |
| Authorized Official Contact | 9312209469 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tun Tavern, Llc 222 Greenbriar Dr Tullahoma TN 37388-8008 Ph: (931) 220-9469 | Tun Tavern, Llc 16 S Central Ave Monteagle TN 37356-3075 Ph: (931) 220-9469 |
| NPI Number | 1386380111 |
|---|---|
| Provider Enumeration Date | 05/05/2022 |
| Last Update Date | 05/05/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386380111 | NPI | - | NPPES |
| 1760436729 | Other | FEDERAL NPI NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
Monteagle Family Dentistry, Pllc. Dental Clinic Medicare: Medicare Enrolled Practice Location: 16 S Central Ave, # 219, Monteagle, TN 37356 Phone: 931-924-2219 Fax: 931-924-2219 |