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NPI Code Detail

MEDICARE: TYLER L. PHELAN DDS PLLC

MEDICARE: TYLER L. PHELAN DDS PLLC
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
1122300000XDentist

General Provider Information

NPI Number : 1316639933
Entity Type Code : Organization
Provider Name (Legal Business Name) : TYLER L. PHELAN DDS PLLC
Provider Business Mailing Address
First Line : 3 HOWARTH AVE
Second Line :
City : ATTLEBORO
State : MA
Zip : 02703-5926
Country : US
Telephone Number : 508-761-5320
Fax Number :
Provider Business Practice Location Address
First Line : 3 HOWARTH AVE
Second Line :
City : ATTLEBORO
State : MA
Zip : 02703-5926
Country : US
Telephone Number : 508-761-5320
Fax Number :
Authorized Official
Title or Position : DENTIST/OWNER
Name : DR. TYLER PHELAN
Credential : DDS
Telephone Number : 508-761-5320
Provider Enumeration Date : 05/23/2023
Last Update Date : 05/23/2023

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Directions to “TYLER L. PHELAN DDS PLLC ” Practice Location

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