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NPI Code Detail

MEDICARE: DR. TARA MCDUFFEY D.D.S.

MEDICARE: DR. TARA MCDUFFEY D.D.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist9615TN

General Provider Information

NPI Number : 1457478091
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TARA MCDUFFEY D.D.S.
Provider Business Mailing Address
First Line : 9629 MILLSFORD CT
Second Line :
City : BRENTWOOD
State : TN
Zip : 37027-8475
Country : US
Telephone Number : 615-364-0170
Fax Number :
Provider Business Practice Location Address
First Line : 927 E BADDOUR PKWY
Second Line :
City : LEBANON
State : TN
Zip : 37087-3706
Country : US
Telephone Number : 615-364-0170
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/26/2007
Last Update Date : 08/19/2014

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