Provider Demographics
NPI:1427434059
Name:KIRKLIN, TYLER (DDS)
Entity type:Individual
Prefix:DR
First Name:TYLER
Middle Name:
Last Name:KIRKLIN
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 1:19 SE 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:PERRYTON
Mailing Address - State:TX
Mailing Address - Zip Code:79070-3111
Mailing Address - Country:US
Mailing Address - Phone:806-435-5335
Mailing Address - Fax:806-435-2811
Practice Address - Street 1:19 SE 5TH AVE
Practice Address - Street 2:
Practice Address - City:PERRYTON
Practice Address - State:TX
Practice Address - Zip Code:79070-3111
Practice Address - Country:US
Practice Address - Phone:806-435-5335
Practice Address - Fax:806-435-2811
Is Sole Proprietor?:No
Enumeration Date:2015-08-05
Last Update Date:2015-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX31001122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist