Provider Demographics
NPI:1568673044
Name:TYLER, CRAIG JAMES (DDS, MSD)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:JAMES
Last Name:TYLER
Suffix:
Gender:M
Credentials:DDS, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:869 CROSSTREE LN
Mailing Address - Street 2:
Mailing Address - City:SANDUSKY
Mailing Address - State:OH
Mailing Address - Zip Code:44870-6550
Mailing Address - Country:US
Mailing Address - Phone:419-621-5464
Mailing Address - Fax:
Practice Address - Street 1:22255 CENTER RIDGE RD STE 204
Practice Address - Street 2:
Practice Address - City:ROCKY RIVER
Practice Address - State:OH
Practice Address - Zip Code:44116-3972
Practice Address - Country:US
Practice Address - Phone:440-333-1007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH192571223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics