| Thomas L Tyree Dds Inc | |
|
1702 Oak St Kenova WV 25530-1120 | |
| (304) 453-6765 | |
| (304) 453-1695 |
| Full Name | Thomas L Tyree Dds Inc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1702 Oak St, Kenova, West Virginia |
| Authorized Official Name and Position | Thomas L Tyree (PRESIDENT) |
| Authorized Official Contact | 3044536765 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Thomas L Tyree Dds Inc 1702 Oak St Kenova WV 25530-1120 Ph: (304) 453-6765 | Thomas L Tyree Dds Inc 1702 Oak St Kenova WV 25530-1120 Ph: (304) 453-6765 |
| NPI Number | 1376612887 |
|---|---|
| Provider Enumeration Date | 11/07/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376612887 | NPI | - | NPPES |
| 0136238000 | Medicaid | WV | |
| 0135603 | Other | WV | DENTAL PROVIDER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 2421 (West Virginia) | Primary |