Provider Demographics
NPI:1629231196
Name:TYLER, OLIN DEAN II (CDT DMD MS PA)
Entity Type:Individual
Prefix:DR
First Name:OLIN
Middle Name:DEAN
Last Name:TYLER
Suffix:II
Gender:M
Credentials:CDT DMD MS PA
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Mailing Address - Street 1:1001 SE OCEAN BLVD STUART PROSTHETIC DENTISTRY
Mailing Address - Street 2:SUITE 102
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34996
Mailing Address - Country:US
Mailing Address - Phone:772-286-1606
Mailing Address - Fax:772-286-2579
Practice Address - Street 1:1001 SE OCEAN BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34996
Practice Address - Country:US
Practice Address - Phone:772-286-1606
Practice Address - Fax:772-286-2579
Is Sole Proprietor?:No
Enumeration Date:2008-07-05
Last Update Date:2022-02-07
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Provider Licenses
StateLicense IDTaxonomies
FLDN18438122300000X, 1223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics
No122300000XDental ProvidersDentist