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General NPI Number Information
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NPI Number | 1811831795
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Entity Type | Organization
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Legal Business Name | TLT ENTERPRISES LLC
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Dates
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Enumeration Date | 04/20/2026
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Last Update Date | 04/20/2026
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Provider Practice Location Address
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Address Line | 1616 SW SUNSET BLVD STE C
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City | PORTLAND
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State | OR
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Zip | 97239-2641
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Country | US
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Telephone | 971-383-5329
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Fax |
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Provider Business Mailing Address
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Address Line | 1616 SW SUNSET BLVD STE C
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City | PORTLAND
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State | OR
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Zip | 97239-2641
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Country | US
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Telephone | 971-383-5329
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. TERRYLYNN TENNANT
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Credential | DMD
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Telephone | 541-915-2047
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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