Individual
TYSON TANNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
117 N MAIN ST, CHARITON, IA 50049-1272
(641) 774-2312
Mailing address
117 N MAIN ST, CHARITON, IA 50049-1272
(641) 774-2312
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
9377
IA
Other
Enumeration date
05/18/2015
Last updated
12/09/2020
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