Provider Demographics
NPI:1144652009
Name:TENNEY, NATHAN PALMER (DMD)
Entity type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:PALMER
Last Name:TENNEY
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9325 W LOUISE DR
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85383
Mailing Address - Country:US
Mailing Address - Phone:623-687-7940
Mailing Address - Fax:
Practice Address - Street 1:18275 N 59TH AVE # C114
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-1260
Practice Address - Country:US
Practice Address - Phone:206-978-1790
Practice Address - Fax:602-978-5211
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD009671122300000X
TX29099122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist