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NPI Code Detail

MEDICARE: DR. TYLER TILDEN BOYNTON D.M.D.

MEDICARE:  DR. TYLER TILDEN BOYNTON  D.M.D.
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
11223S0112XOral and Maxillofacial Surgery (Dentist)63259CA

General Provider Information

NPI Number : 1992934475
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TYLER TILDEN BOYNTON D.M.D.
Provider Business Mailing Address
First Line : 378 PERKINS ST
Second Line :
City : SONOMA
State : CA
Zip : 95476-6827
Country : US
Telephone Number : 707-996-4519
Fax Number :
Provider Business Practice Location Address
First Line : 378 PERKINS ST
Second Line :
City : SONOMA
State : CA
Zip : 95476-6827
Country : US
Telephone Number : 707-996-4519
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/06/2009
Last Update Date : 06/12/2014

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Directions to “ DR. TYLER TILDEN BOYNTON D.M.D.” Practice Location

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