Healthcare Provider Details

I. General information

NPI: 1316639933
Provider Name (Legal Business Name): TYLER L. PHELAN DDS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2023
Last Update Date: 05/23/2023
Certification Date: 05/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 HOWARTH AVE
ATTLEBORO MA
02703-5926
US

IV. Provider business mailing address

3 HOWARTH AVE
ATTLEBORO MA
02703-5926
US

V. Phone/Fax

Practice location:
  • Phone: 508-761-5320
  • Fax:
Mailing address:
  • Phone: 508-761-5320
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: DR. TYLER PHELAN
Title or Position: DENTIST/OWNER
Credential: DDS
Phone: 508-761-5320