Individual
TYE A. ROYLANCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
9652 WASHINGTON ST, THORNTON, CO 80229-2160
(303) 252-4050
(909) 558-4192
Mailing address
9652 WASHINGTON ST, THORNTON, CO 80229-2160
(303) 252-4050
(303) 252-4052
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
10304
CO
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
57738
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10304
—
CO
01
—
57738
STATE LICENSE
CA
Enumeration date
09/30/2008
Last updated
08/07/2020
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