Provider Demographics
NPI:1790065654
Name:TRAMMELL, LAUREN TUCKER (DDS)
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:TUCKER
Last Name:TRAMMELL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3071 KIRBY WHITTEN RD
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:TN
Mailing Address - Zip Code:38134-2822
Mailing Address - Country:US
Mailing Address - Phone:901-382-1564
Mailing Address - Fax:
Practice Address - Street 1:3071 KIRBY WHITTEN RD
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:TN
Practice Address - Zip Code:38134-2822
Practice Address - Country:US
Practice Address - Phone:901-382-1564
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-24
Last Update Date:2011-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN9355122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist