Provider Demographics
NPI:1376037606
Name:TUMLIN, SAMUEL GILREATH (DMD)
Entity Type:Individual
Prefix:
First Name:SAMUEL
Middle Name:GILREATH
Last Name:TUMLIN
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 1:701 N. TENNESSEE ST.
Mailing Address - Street 2:
Mailing Address - City:CARTERSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30120
Mailing Address - Country:US
Mailing Address - Phone:770-382-0100
Mailing Address - Fax:770-382-4857
Practice Address - Street 1:701 N. TENNESSEE ST.
Practice Address - Street 2:
Practice Address - City:CARTERSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30120
Practice Address - Country:US
Practice Address - Phone:770-382-0100
Practice Address - Fax:770-382-4857
Is Sole Proprietor?:No
Enumeration Date:2018-06-20
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN015697122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist