Individual
DR. TYLER DAVID BURNINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1151 E MAIN ST, SUITE A, RADFORD, VA 24141-1761
(540) 639-1674
(540) 639-9205
Mailing address
1151 E MAIN ST, SUITE A, RADFORD, VA 24141-1761
(540) 639-1674
(540) 639-9205
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401412200
VA
Other
Enumeration date
06/26/2008
Last updated
06/26/2008
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