Individual
TYLER ROBERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
450 N KOELLER ST, OSHKOSH, WI 54902-4111
(920) 235-5503
Mailing address
3300 W COLLEGE AVE, APPLETON, WI 54914-3920
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1002080-15
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/15/2019
Last updated
06/04/2021
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