Provider Demographics
NPI:1295343879
Name:MEISTER, TYLER (DMD)
Entity type:Individual
Prefix:
First Name:TYLER
Middle Name:
Last Name:MEISTER
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 1:154 ASHLEY CT
Mailing Address - Street 2:
Mailing Address - City:SPEEDWELL
Mailing Address - State:TN
Mailing Address - Zip Code:37870-7980
Mailing Address - Country:US
Mailing Address - Phone:606-273-4380
Mailing Address - Fax:
Practice Address - Street 1:181 POWELL VALLEY SCHOOL LN
Practice Address - Street 2:
Practice Address - City:SPEEDWELL
Practice Address - State:TN
Practice Address - Zip Code:37870-7431
Practice Address - Country:US
Practice Address - Phone:423-419-5070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-20
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN11345122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist