Individual
DR. TYLER BENTON BLOUNT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
8013 NEW LA GRANGE RD STE 6, LOUISVILLE, KY 40222-4700
(502) 425-7068
Mailing address
304 MCARTHUR DR, LOUISVILLE, KY 40207-2265
(502) 396-8895
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
10098
KY
Other
Enumeration date
05/17/2018
Last updated
05/28/2019
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