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Individual
DR. TYLER LANE PITTMAN
Active
Individual
DR. TYLER LANE PITTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401410222
VA
1223G0001X
General Practice Dentistry
DS0000007776
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
061550
BCBS OF VA
VA
01
—
1300698
UNITED CONCORDIA
VA
01
—
3158606
BCBS OF TN
TN
Enumeration date
10/04/2006
Last updated
07/08/2007
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