Individual
TYLER JOHNSON
Active
Individual
TYLER JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
56144
CA
1223D0004X
Dental Anesthesiology
Primary
1498
CA
Other
Enumeration date
12/04/2008
Last updated
06/25/2019
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