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Organization
DR. MATT TYSON, DDS, PC
Active
Organization
DR. MATT TYSON, DDS, PC
Active
Other names
Tyson Family Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATT A TYSON D.D.D (PRESIDENT)
(214) 675-9116
Entity
Organization
Contact information
Practice address
8113 CAMP BOWIE WEST BLVD, BENBROOK, TX 76116-6314
(817) 560-9300
(817) 560-9303
Mailing address
8113 CAMP BOWIE WEST BLVD, BENBROOK, TX 76116-6314
(817) 560-9300
(817) 560-9303
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
24696
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1578799250
—
TX
Enumeration date
06/29/2016
Last updated
06/29/2016
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