Provider Demographics
NPI:1386788727
Name:TATE, DON L (DDS)
Entity type:Individual
Prefix:DR
First Name:DON
Middle Name:L
Last Name:TATE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3117 MOUNT ZION RD
Mailing Address - Street 2:
Mailing Address - City:UPPERCO
Mailing Address - State:MD
Mailing Address - Zip Code:21155-9482
Mailing Address - Country:US
Mailing Address - Phone:410-374-8888
Mailing Address - Fax:
Practice Address - Street 1:111 WARREN RD STE 1A
Practice Address - Street 2:
Practice Address - City:COCKEYSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21030-3362
Practice Address - Country:US
Practice Address - Phone:410-666-8383
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD8335122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist