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General NPI Number Information
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NPI Number | 1376995456
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Entity Type | Organization
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Legal Business Name | BRANDON TYLER DDS PLLC
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Dates
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Enumeration Date | 07/12/2016
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Last Update Date | 03/24/2025
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Provider Practice Location Address
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Address Line | 26504 NE VALLEY ST
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City | DUVALL
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State | WA
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Zip | 98019
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Country | US
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Telephone | 360-710-5015
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Fax |
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Provider Business Mailing Address
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Address Line | 26504 NE VALLEY ST PO BOX 1180
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City | DUVALL
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State | WA
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Zip | 98019
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Country | US
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Telephone | 360-710-5015
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Fax |
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Authorized Official
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Title or Position | OWNER/DDS
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Name | BRANDON TYLER
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Credential |
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Telephone | 360-710-5015
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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