Individual
TYLER TOMKINSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
13601 N CANTERBURY DR, PHOENIX, AZ 85023
(480) 221-5080
Mailing address
1776 E CABORCA DR, CASA GRANDE, AZ 85122-6381
(480) 221-5080
Taxonomy
Speciality
Code
Description
License number
State
1223D0004X
Dental Anesthesiology
Primary
D10072
AZ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
404557
—
AZ
Enumeration date
06/19/2014
Last updated
08/31/2018
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