IndividualActive
Mary Tatum, DMD
NPI 1003033192 · General Practice Dentistry · Charleston, SC
Provider details
- NPI number
- 1003033192
- Entity type
- Individual
- Primary specialty
- General Practice DentistryDental Providers
- Credential
- DMD
- Sex
- Female
- Sole proprietor
- Yes
- License
- 3084 (SC)
Specialties & taxonomies
Dental Providers
Practice location
92 Courtenay Dr
Charleston, SC 29403-5742
Phone: (843) 577-6112
Fax: (843) 937-0200
Approximate (ZIP-level) locationGet directions
Mailing address
92 Courtenay Dr
Charleston, SC 29403-5742
Registry dates
- Enumerated
- 2007-04-19
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.