Individual
AUSTIN TYLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2501 CAPEHART RD, OFFUTT AFB, NE 68113-1043
(210) 292-0123
Mailing address
2501 CAPEHART RD, OFFUTT AFB, NE 68113-1043
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DEN.00204403
CO
1223P0700X
Prosthodontics
Primary
DEN.00204403
CO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/04/2020
Last updated
07/10/2024
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