Provider Demographics
NPI:1881303485
Name:TYLER J. DELAET, DMD, LLC
Entity type:Organization
Organization Name:TYLER J. DELAET, DMD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TYLER
Authorized Official - Middle Name:JEFFREY
Authorized Official - Last Name:DELAET
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:513-741-8223
Mailing Address - Street 1:3475 N BEND RD STE 1
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45239-8602
Mailing Address - Country:US
Mailing Address - Phone:513-741-8223
Mailing Address - Fax:513-741-8234
Practice Address - Street 1:3475 N BEND RD STE 1
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45239-8602
Practice Address - Country:US
Practice Address - Phone:513-741-8223
Practice Address - Fax:513-741-8234
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-22
Last Update Date:2022-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental