Provider Demographics
NPI:1871719773
Name:YOUNG & TANNER, LLC
Entity type:Organization
Organization Name:YOUNG & TANNER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCTS. MGR.
Authorized Official - Prefix:MS
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:LIN
Authorized Official - Last Name:PUGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-973-7227
Mailing Address - Street 1:1000 JOHNSON FERRY RD.
Mailing Address - Street 2:BLDG. A, SUITE 100
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30068
Mailing Address - Country:US
Mailing Address - Phone:770-973-8911
Mailing Address - Fax:770-509-7403
Practice Address - Street 1:1000 JOHNSON FERRY RD.
Practice Address - Street 2:BLDG A, SUITE 100
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30068
Practice Address - Country:US
Practice Address - Phone:770-973-8911
Practice Address - Fax:770-509-7403
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
Last Update Date:2014-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADNO126291223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty