Individual
TYLER WOODLING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
550 S JACKSON ST, LOUISVILLE, KY 40202-1622
(502) 648-9915
Mailing address
550 S JACKSON ST, LOUISVILLE, KY 40202-1622
(502) 648-9915
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
3443
OH
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
9629
KY
Other
Enumeration date
07/02/2014
Last updated
07/16/2015
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