Individual
DR. TYLER H JOLLEY
Active
Individual
DR. TYLER H JOLLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
53318729922
UT
1223P0300X
Periodontics
9143
CO
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
53318729922
UT
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
9143
CO
Other
Enumeration date
09/22/2006
Last updated
05/13/2010
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