person
Mr. Kevin M Tatlock, LD
Denturist in Ontario, Oregon
NPI 1649381062

Kevin M Tatlock is a Denturist based in Ontario, OR. Kevin M Tatlock practices in Ontario, OR and has the professional credentials of LD. The NPI Number for Kevin M Tatlock is 1649381062 and holds a License No. DT-DO-854277 (Oregon).

The current practice location address for Kevin M Tatlock is 473 Sw 12Th St, Ontario, OR and can be reached out via phone at 541-889-3282 and via fax at 541-881-0653. You can also correspond with Kevin M Tatlock through the mailing address at 473 SW 12TH ST, ONTARIO, OR - 97914-3201 (mailing address contact number: 541-889-3282).

Location: 473 Sw 12Th St, Ontario, OR, 97914-3201
person
Provider Profile Details
NPI Number
1649381062
Provider Name
Kevin M Tatlock
Credential
LD
Provider Entity Type
Individual
Gender
Male
Address
473 Sw 12Th St, Ontario, OR, 97914-3201
Phone Number
541-889-3282
Fax Number
541-881-0653
Provider Enumeration Date
08/31/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
125851 05 OR
institution
Provider Business Practice Location Address Details
Address
473 Sw 12Th St
City
State
Zip
97914-3201
Phone Number
541-889-3282
Fax Number
541-881-0653
person
Provider Business Mailing Address Details
Address
473 Sw 12Th St
City
State
Zip
97914-3201
Phone Number
541-889-3282
Fax Number
541-881-0653
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Denturist
Speciality
-
Taxonomy
License No.
DT-DO-854277 (Oregon)
Definition
Definition to come.
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