NPI 1124470695

Jaquita Larshe Tate

Practitioner Dental Assistant Ft. Stewart, GA

Practice location

Address: 305 Vanguard Rd, Ft. Stewart, GA 31314
Phone: (912) 435-5705

Registered specialties

Dental Assistant Primary

Dental Providers Taxonomy 126800000X

Other Dental Assistant providers in Georgia →

Registry record

NPI: 1124470695
Entity type: Individual
Sex (as registered): Female
NPI issued: 8 Jul 2016
Record last updated: 8 Jul 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.