MEDICARE: DR. TYLER R ALBRECHT DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223P0221X	Pediatric Dentistry	63359359921	UT

General Provider Information

NPI Number	:	1063530269
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TYLER R ALBRECHT DMD

Provider Business Mailing Address
First Line	:	1251 NORTHFIELD RD
Second Line	:
City	:	CEDAR CITY
State	:	UT
Zip	:	84720-8916
Country	:	US
Telephone Number	:	435-586-8188
Fax Number	:

Provider Business Practice Location Address
First Line	:	1251 NORTHFIELD RD
Second Line	:
City	:	CEDAR CITY
State	:	UT
Zip	:	84720-8916
Country	:	US
Telephone Number	:	435-586-8188
Fax Number	:	435-867-1362

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/26/2007
Last Update Date	:	03/17/2025

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