Tyler Freeman
Individual provider Active NPI General Practice Dentistry · Malmstrom Afb, MT
NPI 1326733718 · NPPES record last updated Aug 5, 2024
Key facts
- NPI
- 1326733718
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 30.027121 (OH)
- Practice address
- 7300 N Perimeter Rd
Malmstrom Afb, MT 59402-6701 - Phone
- (406) 731-2531
- NPI assigned
- Apr 10, 2023
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30.027121 | OH | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 30.027121 | OH | Yes |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
7300 N Perimeter Rd
Malmstrom Afb, MT 59402-6701
Mailing address
7300 N Perimeter Rd
Malmstrom Afb, MT 59402-6701
Phone (406) 731-2531
Other providers in Malmstrom Afb, MT
- Wade S Dinse
- Maggie Lea Dutcher
- Rachel Elder
- Paxton Anne Farias
- Daniel Ray Fisher
- Timothy Paul Gacioch
- Elijah Jacob Grayson
- Laurie Carrin Harper
- Elaine Harris
- Jennifer Bradley Harward
All providers in Malmstrom Afb, MT · General Practice Dentistry in Montana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 5, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.