Individual
DR. TYLER BLINCOE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
12 ORPHANAGE RD, FORT MITCHELL, KY 41017-3072
(859) 331-1960
Mailing address
13 W HENRY CLAY AVE, COVINGTON, KY 41011-3612
(859) 663-5414
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
10501
KY
122300000X
Dentist
30.026228
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10501
KENTUCKY BOARD OF DENTISTRY
KY
01
—
30.026228
OHIO STATE DENTAL BOARD
OH
Enumeration date
07/22/2020
Last updated
07/22/2020
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