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General NPI Number Information
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NPI Number | 1407372949
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Entity Type | Organization
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Legal Business Name | JAMES M. TINNIN, D.D.S., M.S.D, P.A.
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Dates
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Enumeration Date | 08/16/2017
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Last Update Date | 08/16/2017
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Provider Practice Location Address
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Address Line | 1831 N GREEN ACRES RD
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City | FAYETTEVILLE
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State | AR
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Zip | 72703-2615
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Country | US
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Telephone | 479-521-2814
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Fax |
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Provider Business Mailing Address
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Address Line | 1831 N GREEN ACRES RD
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City | FAYETTEVILLE
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State | AR
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Zip | 72703-2615
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. MARY BETH MCPHERSON
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Credential |
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Telephone | 479-521-2814
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number |
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License Number State | AR
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