Provider Demographics
NPI:1689200099
Name:SYKES, TYLER DAVID (DMD)
Entity Type:Individual
Prefix:DR
First Name:TYLER
Middle Name:DAVID
Last Name:SYKES
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1477 SNOWBERRY LN
Mailing Address - Street 2:
Mailing Address - City:PULLMAN
Mailing Address - State:WA
Mailing Address - Zip Code:99163-6004
Mailing Address - Country:US
Mailing Address - Phone:331-330-0805
Mailing Address - Fax:
Practice Address - Street 1:650 SE BISHOP BLVD STE 200
Practice Address - Street 2:
Practice Address - City:PULLMAN
Practice Address - State:WA
Practice Address - Zip Code:99163-5966
Practice Address - Country:US
Practice Address - Phone:509-332-2366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-17
Last Update Date:2020-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA609530421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice