Richard C Tatum Jr, DDS | |
167 N. Main St, Tuba City, AZ 86045 | |
(928) 283-2672 | |
(928) 283-2991 |
Full Name | Richard C Tatum Jr |
---|---|
Gender | Male |
Speciality | Dentist - General Practice |
Location | 167 N. Main St, Tuba City, Arizona |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1710096706 | NPI | - | NPPES |
888927 | Medicaid | AZ |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | 12754 (Maryland) | Secondary |
1223G0001X | Dentist - General Practice | D6672 (Arizona) | Primary |
Entity Name | Tuba City Regional Health Care Corporation |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1548294424 PECOS PAC ID: 4284542531 Enrollment ID: O20031105000107 |
Mailing Address | Practice Location Address |
---|---|
Richard C Tatum Jr, DDS 3008 E. Birch Ave, Tuba City, AZ 86045-0600 Ph: (928) 283-2672 | Richard C Tatum Jr, DDS 167 N. Main St, Tuba City, AZ 86045 Ph: (928) 283-2672 |
Dr. Kyle Minter Parks, D.M.D. Dentist Medicare: Not Enrolled in Medicare Practice Location: 167 N Main St., Tuba City, AZ 86045 Phone: 928-283-2672 | |
Dr. Hannah Noel Despain, DMD Dentist Medicare: Medicare Enrolled Practice Location: 167 Main Street, Tuba City, AZ 86045 Phone: 502-851-2734 | |
Ivan F Pacheco, DMD Dentist Medicare: Not Enrolled in Medicare Practice Location: 167 North Main Street, Tuba City, AZ 86045 Phone: 928-283-2501 Fax: 928-283-2677 | |
Dr. Kristin Elizabeth Salamon, D.D.S. Dentist Medicare: Medicare Enrolled Practice Location: 167 N Main St, Tuba City, AZ 86045 Phone: 928-283-2501 Fax: 928-283-2677 | |
Robert A Palmer, DMD Dentist Medicare: Not Enrolled in Medicare Practice Location: 167 North Main Street, Tuba City, AZ 86045 Phone: 928-283-2501 Fax: 928-283-2677 | |
Teresa Diane Kilborn, D.M.D Dentist Medicare: Not Enrolled in Medicare Practice Location: 167 N. Main Street, Tuba City, AZ 86045 Phone: 928-283-2590 Fax: 928-283-2591 | |
Christina L. Zeigler, D.D.S. Dentist Medicare: Medicare Enrolled Practice Location: 167 N. Main St, Tuba City, AZ 86045 Phone: 928-283-2672 Fax: 928-283-2991 |