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General NPI Number Information
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NPI Number | 1275059883
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Entity Type | Individual
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Provider Name | TYLER VILLIARD DMD
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Gender | Male
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Dates
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Enumeration Date | 08/15/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 65 SCHOOL ST
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City | CARLISLE
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State | IA
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Zip | 50047-8782
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Country | US
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Telephone | 515-989-3180
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Fax | 515-989-2071
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Provider Business Mailing Address
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Address Line | 65 SCHOOL ST
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City | CARLISLE
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State | IA
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Zip | 50047-8782
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Country | US
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Telephone | 515-989-3180
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Fax | 515-989-2071
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DDS-0
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DDS-09443
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License Number State | IA
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