Mabry, Tad Rutledge
Mabry, Tad Rutledge is an individual health care provider with primary practice located at 201 Dsb South University Of Iowa College Of Dentistry, Iowa City IA 52242-1001. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Mabry, Tad Rutledge can be contacted via phone (319) 335-7487.Contact Information
Primary practice address
201 Dsb South University Of Iowa College Of Dentistry
Iowa City IA 52242-1001
Phone: (319) 335-7487
Fax: (319) 353-5508
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | 74837 | Oklahoma |
| Dental Providers / Dentist | 122300000X | 40114 | Iowa |
| Dental Providers / Dentist | 122300000X | 4837 | Oklahoma |
Profile Details
| NPI number | 1558424051 |
|---|---|
| LBN Legal business name | Mabry, Tad Rutledge |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 18th, 2006 |
| Last updated | Mar 18th, 2010 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1558424051 | NPPES |
| Oklahoma | MEDICAID | 1300818 |
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