Tewogbade, Tara

Tewogbade, Tara is an individual health care provider with primary practice located at 374 N Deshon Rd Ste D , Stone Mountain GA 30087-4827. She recently has 2 registered licenses in different health care specialties including Dental Providers / Dentist, Dental Providers / General Practice. Dental Providers / General Practice is her primary health care specialty. Tewogbade, Tara can be contacted via phone (770) 469-4192.

Contact Information

Primary practice address
374 N Deshon Rd Ste D Stone Mountain GA 30087-4827
Phone: (770) 469-4192
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 8254 North Carolina
Dental Providers / General Practice 1223G0001X DN013995 Georgia

Profile Details

NPI number 1447454236
LBN Legal business name Tewogbade, Tara
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 13th, 2007
Last updated Mar 15th, 2012 - about 13 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.

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