Provider Demographics
NPI:1760442909
Name:TANKSLEY, GEORGE ARTHUR JR (DMD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:ARTHUR
Last Name:TANKSLEY
Suffix:JR
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1218 SW MILITARY DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78221-1535
Mailing Address - Country:US
Mailing Address - Phone:210-928-2814
Mailing Address - Fax:210-928-2364
Practice Address - Street 1:10710 RESEARCH BLVD
Practice Address - Street 2:SUITE 302
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-5798
Practice Address - Country:US
Practice Address - Phone:512-568-3500
Practice Address - Fax:512-372-4528
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-23
Last Update Date:2010-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV4619T1223G0001X
NJ22DI020449001223G0001X
TX23816122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice