Tyndall, Phillip Alan

Tyndall, Phillip Alan is an sole proprietor health care provider with primary practice located at 415 E Hartford Ave , Ponca City OK 74601-1512. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Tyndall, Phillip Alan can be contacted via phone (580) 762-7857.

Contact Information

Primary practice address
415 E Hartford Ave Ponca City OK 74601-1512
Fax: (580) 762-2788
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 5342 Oklahoma

Profile Details

NPI number 1477540813
LBN Legal business name Tyndall, Phillip Alan
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 30th, 2005
Last updated Apr 24th, 2008 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1477540813 NPPES
Oklahoma MEDICAID 100126460A

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