Individual
TYLER ROBERT KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1111 E MCDOWELL RD, PHOENIX, AZ 85006-2612
(417) 203-0622
Mailing address
1441 N 12TH ST, PHOENIX, AZ 85006-2837
(417) 209-0622
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
27.00364699
AZ
Other
Enumeration date
04/19/2019
Last updated
04/19/2019
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