Individual
DR. TYLER RYAN MULLINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
37290 OLD PERKINS RD, PRAIRIEVILLE, LA 70769-3764
(225) 677-9999
Mailing address
37290 OLD PERKINS RD, PRAIRIEVILLE, LA 70769-3764
(225) 677-9999
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7324
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
68721
—
LA
Enumeration date
05/31/2022
Last updated
11/15/2022
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