Provider Demographics
NPI:1306911391
Name:TYLKA, DANIEL F (DMD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:F
Last Name:TYLKA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:875 UNION AVE C 515
Mailing Address - Street 2:UTHSC COLLEGE OF DENTISTRY
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38163-2110
Mailing Address - Country:US
Mailing Address - Phone:901-448-6930
Mailing Address - Fax:901-448-1294
Practice Address - Street 1:875 UNION AVE
Practice Address - Street 2:UTHSC COLLEGE OF DENTISTRY - UDFP
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38163-2110
Practice Address - Country:US
Practice Address - Phone:901-448-6930
Practice Address - Fax:901-448-1294
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-22
Last Update Date:2019-10-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS616801223X2210X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X2210XDental ProvidersDentistOrofacial Pain