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Individual

TYLER GEYEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
465 MEMORIAL DR, POCATELLO, ID 83201-4008
(208) 282-3289
Mailing address
1301 HAWTHORNE ST, ALEXANDRIA, MN 56308-2555
(320) 762-0279

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D13374
MN

Other

Enumeration date
06/18/2014
Last updated
07/06/2015
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