Provider Demographics
NPI:1285366682
Name:TYURIN, ALEX (DDS)
Entity type:Individual
Prefix:
First Name:ALEX
Middle Name:
Last Name:TYURIN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4911 E STREET RD UNIT B
Mailing Address - Street 2:
Mailing Address - City:FEASTERVILLE TREVOSE
Mailing Address - State:PA
Mailing Address - Zip Code:19053-7709
Mailing Address - Country:US
Mailing Address - Phone:267-990-8668
Mailing Address - Fax:
Practice Address - Street 1:4911 E STREET RD UNIT B
Practice Address - Street 2:
Practice Address - City:FEASTERVILLE TREVOSE
Practice Address - State:PA
Practice Address - Zip Code:19053-7709
Practice Address - Country:US
Practice Address - Phone:267-990-8668
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-26
Last Update Date:2022-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS043752122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist