Individual
DR. TYLER CHANCELLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4016 LEMAY FERRY RD, SAINT LOUIS, MO 63129-1858
(303) 305-4062
Mailing address
716 WILLIAMSBURG BLVD, EDWARDSVILLE, IL 62025-5538
(303) 915-4694
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
00204788
CO
Other
Enumeration date
06/23/2021
Last updated
08/10/2024
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