| NPI | 1003811100 |
|---|---|
| Former Legal Business Name | JOHN MICHAEL TATE DDS PA |
| Entity Type | Organization |
| Authorized Contact | JOHN TYLER TATE Secretary 817-481-6364 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX TX11540) |
| Enumeration Date | 2005-06-15 |
| Last Update Date | 2014-12-15 |