Provider Demographics
NPI:1154466332
Name:CHRISTOPHER M TYLER DDS PC
Entity Type:Organization
Organization Name:CHRISTOPHER M TYLER DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:M
Authorized Official - Last Name:TYLER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:319-366-8095
Mailing Address - Street 1:126 2ND ST NE
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52401-1103
Mailing Address - Country:US
Mailing Address - Phone:319-366-8095
Mailing Address - Fax:319-364-4480
Practice Address - Street 1:126 2ND ST NE
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52401-1103
Practice Address - Country:US
Practice Address - Phone:319-366-8095
Practice Address - Fax:319-364-4480
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA78411223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty