Provider Demographics
NPI:1194085977
Name:TALLENT, STEVEN M II (DMD)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:M
Last Name:TALLENT
Suffix:II
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 1:1225 N. MAIN ST.
Mailing Address - Street 2:BRUMMETT COSMETIC AND FAMILY DENTISTRY
Mailing Address - City:MONTICELLO
Mailing Address - State:KY
Mailing Address - Zip Code:42633
Mailing Address - Country:US
Mailing Address - Phone:606-340-0740
Mailing Address - Fax:606-340-0742
Practice Address - Street 1:1225 N. MAIN ST.
Practice Address - Street 2:BRUMMETT COSMETIC AND FAMILY DENTISTRY
Practice Address - City:MONTICELLO
Practice Address - State:KY
Practice Address - Zip Code:42633
Practice Address - Country:US
Practice Address - Phone:606-340-0740
Practice Address - Fax:606-340-0742
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-25
Last Update Date:2012-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY9171122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist