Provider Demographics
NPI:1932284924
Name:DRS. TINNIN,HARRIS & MARTIN,DDS,PLLC
Entity Type:Organization
Organization Name:DRS. TINNIN,HARRIS & MARTIN,DDS,PLLC
Other - Org Name:FAMILY DENTAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:P
Authorized Official - Last Name:TINNIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:479-442-8500
Mailing Address - Street 1:2386 N GREEN ACRES
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703
Mailing Address - Country:US
Mailing Address - Phone:479-442-8500
Mailing Address - Fax:479-442-2933
Practice Address - Street 1:2386 N GREEN ACRES
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703
Practice Address - Country:US
Practice Address - Phone:479-442-8500
Practice Address - Fax:479-442-2933
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty