Individual
TYLER BIANCA DUFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
20311 S ELLSWORTH RD STE 101, QUEEN CREEK, AZ 85142-2400
(480) 999-4484
Mailing address
2631 E BLUE SPRUCE LN, GILBERT, AZ 85298-3422
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D011858
AZ
1223G0001X
General Practice Dentistry
D011858
AZ
Other
Enumeration date
06/16/2023
Last updated
06/16/2023
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