Provider Demographics
NPI:1861928202
Name:RAANNE RAY TINDLE D.M.D., P.A.
Entity type:Organization
Organization Name:RAANNE RAY TINDLE D.M.D., P.A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAANNE
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:TINDLE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:662-846-1570
Mailing Address - Street 1:601 W SUNFLOWER RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:MS
Mailing Address - Zip Code:38732-2527
Mailing Address - Country:US
Mailing Address - Phone:662-846-1570
Mailing Address - Fax:662-846-1576
Practice Address - Street 1:601 W SUNFLOWER RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:MS
Practice Address - Zip Code:38732-2527
Practice Address - Country:US
Practice Address - Phone:662-846-1570
Practice Address - Fax:662-846-1576
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-04
Last Update Date:2017-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty