# TYLER NELSON, DDS, CORP.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134730914
- **Authorized official:** TYLER NELSON DDS (OWNER)
- **Authorized official phone:** (719) 722-0540

## Contact information

- **Practice address:** 950 BOARDWALK STE 100, SAN MARCOS, CA 92078-2600
- **Practice address phone:** (760) 644-5494
- **Mailing address:** 950 BOARDWALK STE 100, SAN MARCOS, CA 92078-2600
- **Mailing address phone:** (760) 644-5494

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |

## Other

- **Enumeration date:** 08/13/2020
- **Last updated:** 07/08/2022