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14703 1st Ln Ne Ste 203 Duvall WA 98019-8470 | |
| (425) 788-2626 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 14703 1st Ln Ne Ste 203, Duvall, Washington |
| Authorized Official Name and Position | Brandon Tyler (OWNER/DDS) |
| Authorized Official Contact | 4257882626 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
14703 1st Ln Ne Ste 203 Duvall WA 98019-8470 Ph: (425) 788-2626 | 14703 1st Ln Ne Ste 203 Duvall WA 98019-8470 Ph: (425) 788-2626 |
| NPI Number | 1376995456 |
|---|---|
| Provider Enumeration Date | 07/12/2016 |
| Last Update Date | 07/12/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376995456 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DE60488503 (Washington) | Primary |
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