Individual
DR. DUTRAN TYLER DO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD, DMD
Contact information
Practice address
12401 WILSHIRE BLVD STE 104, LOS ANGELES, CA 90025-1015
(203) 200-7280
Mailing address
12401 WILSHIRE BLVD STE 104, LOS ANGELES, CA 90025-1015
(203) 200-7280
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
052760
NY
122300000X
Dentist
64626
CA
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
049194
CT
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
257471
NY
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
C139636
CA
Other
Enumeration date
11/02/2006
Last updated
02/27/2022
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