Individual
TYLER OWENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
3100 E ZORA ST, WEBB CITY, MO 64870-9770
(417) 228-8286
(512) 442-6074
Mailing address
400 RIVERWALK TER STE 250, JENKS, OK 74037-5619
(918) 998-0996
(918) 235-9079
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
6969
OK
1223P0221X
Pediatric Dentistry
106
OK
1223P0221X
Pediatric Dentistry
Primary
2019005272
MO
1223P0221X
Pediatric Dentistry
61520
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200715230A
—
OK
05
—
201253250A
—
KS
05
—
830082149
—
MO
Enumeration date
02/25/2015
Last updated
08/19/2025
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