Individual
TYLER JAMES JACQUES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
335 C ST SE, WASHINGTON, DC 20003-2002
(202) 543-0700
Mailing address
335 C ST SE, WASHINGTON, DC 20003-2002
(202) 543-0700
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
019028847
IL
1223G0001X
General Practice Dentistry
Primary
DEN1001691
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1891225603
ORGANIZATIONAL NPI
—
Enumeration date
09/06/2011
Last updated
07/21/2022
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