Most Relevant Information
Provider Data
| NPI Number: | 1003033192 |
| Provider Name: | MARY VICTORIA TATUM DMD |
| Entity Type: | Individual |
| Taxonomy Code: | 1223G0001X |
| Specialty: | Dentist |
| License Number: | 3084 |
Most Important Dates
| Enumeration Date: | 04/19/2007 |
| Last Updated: | 07/08/2007 |
Provider Practice Location
92 COURTENAY DR
CHARLESTON
SC
294035742
Practice Location Phone/Fax
| Phone: | 8435776112 |
| Fax: | 8439370200 |
Provider Mailing Location
92 COURTENAY DR
CHARLESTON
SC
294035742
Provider Mailing Phone/Fax
| Phone: | 8435776112 |
| Fax: | 8439370200 |