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Individual

DR. TYLER ROSS DEROUIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1136 WASHINGTON AVE, DETROIT LAKES, MN 56501-3411
(218) 847-2624
(218) 847-5792
Mailing address
1136 WASHINGTON AVE, DETROIT LAKES, MN 56501-3411
(218) 847-2624
(218) 847-5792

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D13417
MN

Other

Enumeration date
06/23/2014
Last updated
06/23/2014
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