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Individual

TYLER HARADON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
685 CITADEL DR E STE 200A, COLORADO SPRINGS, CO 80909-5315
(719) 574-4867
Mailing address
685 CITADEL DR E STE 200A, COLORADO SPRINGS, CO 80909-5315
(719) 574-4867

Taxonomy

Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
204636
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
7195744867
OTHER
Enumeration date
06/24/2021
Last updated
06/24/2021
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