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DR. TYLER LEE CLARK DDS

Dental Providers Dentist Oral and Maxillofacial Surgery

Provider NPI: 1578542361

Provider Information:
DR. TYLER LEE CLARK DDS
Gender: M
Not Sole Proprietor

Practice Location:
330 S GARDEN WAY STE 140 EUGENE, OR 97401-8176 US
Tel: 541-686-9750  Fax: 541-485-5034

Business Mailing Address:
330 S GARDEN WAY STE 140 EUGENE, OR 97401-8176 US
Tel: 541-686-9750  Fax: 541-485-5034

NPI Information:
NPI: 1578542361
Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y1223S0112XDental Providers
Dentist
Oral and Maxillofacial Surgery
ORD10177

Other Provider Identifiers:

IssuerNumberStateType
500684192OR05



American Medical Association 2012 taxonomy code information

Code: 1223S0112X

Type:

Classification:



Definition:



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