Individual
DR. TYLER LAYTON HENDRICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
813 N STILSON RD, BOISE, ID 83703-5119
(208) 342-4644
(208) 375-8208
Mailing address
813 N STILSON RD, BOISE, ID 83703-5119
(208) 342-4644
(208) 375-8208
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D-5062
ID
Other
Enumeration date
06/26/2019
Last updated
06/26/2019
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