Individual
DR. TYLER MARK WHITING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1903 WILMINGTON DR UNIT 101, FORT COLLINS, CO 80528-6100
(970) 568-5255
Mailing address
486 WEST FIRST AVE, GLENNS FERRY, ID 83623
(208) 366-7416
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
D-4670
ID
1223E0200X
Endodontics
Primary
00204685
CO
Other
Enumeration date
06/18/2015
Last updated
12/28/2021
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