Individual
DR. TYLER RYAN MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
510 E 8TH ST, MCMINNVILLE, OR 97128-3910
(503) 472-3147
(503) 435-1451
Mailing address
510 E 8TH ST, MCMINNVILLE, OR 97128-3910
(503) 472-3147
(503) 435-1451
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D9740
OR
Other
Enumeration date
07/13/2012
Last updated
07/13/2012
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