Individual
DR. TYLER JAMES BANACHOWSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3250 ZEMKE AVE, TAMPA, FL 33621
(813) 827-9400
Mailing address
3250 ZEMKE AVE, TAMPA, FL 33621-5023
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
9283
NC
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
DN24505
FL
Other
Enumeration date
03/12/2012
Last updated
09/13/2019
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