Individual
DR. TYSEN WOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
3877 E AMITY RD, MERIDIAN, ID 83642-8380
(208) 900-4669
Mailing address
3877 E AMITY RD, MERIDIAN, ID 83642-8380
(208) 900-4669
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1002293-15
WI
Other
Enumeration date
06/11/2020
Last updated
03/26/2025
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