Individual
TYLER J WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
4940 HAMRICK RD, CENTRAL POINT, OR 97502-3072
(541) 690-3600
(541) 664-3735
Mailing address
931 CHEVY WAY, MEDFORD, OR 97504-4127
(541) 690-3555
(541) 842-2212
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D10115
OR
Other
Enumeration date
08/06/2014
Last updated
04/14/2020
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