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Contact Information

JAQUITA L TATE
305 VANGUARD RD
FORT STEWART, GA31314
 Phone: 912-435-5705
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dental Assistant

126800000X
Indicates primary specialty

NPI Profile & details for JAQUITA L TATE · (Female)

NPI Number 1124470695
Status Active
Credentials
Entity Individual
Enumeration date 07/08/2016
Last updated 07/08/2016 - About 10 years ago
Sole proprietor 1 No
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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