Provider Demographics
NPI:1922136027
Name:TRYON, DWIGHT MAYNARD (DDS)
Entity Type:Individual
Prefix:DR
First Name:DWIGHT
Middle Name:MAYNARD
Last Name:TRYON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2145 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:OROVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95965-5870
Mailing Address - Country:US
Mailing Address - Phone:530-534-5394
Mailing Address - Fax:530-533-1323
Practice Address - Street 1:2145 5TH. AVE.
Practice Address - Street 2:
Practice Address - City:OROVILLE
Practice Address - State:CA
Practice Address - Zip Code:95965-5870
Practice Address - Country:US
Practice Address - Phone:530-534-5394
Practice Address - Fax:530-533-1323
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2016-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA379441223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice