Provider Demographics
NPI:1477679371
Name:TYLER,DUMAS,REYES SPECIALISTS IN ORTHODONTICS, P.C.
Entity Type:Organization
Organization Name:TYLER,DUMAS,REYES SPECIALISTS IN ORTHODONTICS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:A
Authorized Official - Last Name:TYLER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS MS
Authorized Official - Phone:248-258-8283
Mailing Address - Street 1:2388 COLE ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:BIRMINGHAM
Mailing Address - State:MI
Mailing Address - Zip Code:48009-7009
Mailing Address - Country:US
Mailing Address - Phone:248-258-8283
Mailing Address - Fax:248-258-8285
Practice Address - Street 1:2388 COLE ST
Practice Address - Street 2:SUITE 103
Practice Address - City:BIRMINGHAM
Practice Address - State:MI
Practice Address - Zip Code:48009-7009
Practice Address - Country:US
Practice Address - Phone:248-258-8283
Practice Address - Fax:248-258-8285
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010149941223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty