MEDICARE: DR. TYLER M CHRISTENSEN D.D.S.

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	1223G0001X	General Practice Dentistry	4770	NV

General Provider Information

NPI Number	:	1073684569
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TYLER M CHRISTENSEN D.D.S.

Provider Business Mailing Address
First Line	:	10521 JEFFREYS ST SUITE 200
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89052-6598
Country	:	US
Telephone Number	:	702-331-2121
Fax Number	:	702-331-1616

Provider Business Practice Location Address
First Line	:	10521 JEFFREYS ST STE 200
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89052-4181
Country	:	US
Telephone Number	:	702-331-2121
Fax Number	:	702-331-1616

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

Provider Enumeration Date	:	11/13/2006
Last Update Date	:	11/03/2017

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