Maxwell, Tyler J

Maxwell, Tyler J is an individual health care provider with primary practice located at 511 E Genesee St , Fayetteville NY 13066-1524. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Dental Providers / General Practice. Dental Providers / General Practice is his primary health care specialty. Maxwell, Tyler J can be contacted via phone (315) 637-4616.

Contact Information

Primary practice address
511 E Genesee St Fayetteville NY 13066-1524
Phone: (315) 637-4616
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Dental Providers / General Practice 1223G0001X 059837 New York

Profile Details

NPI number 1396273298
LBN Legal business name Maxwell, Tyler J
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date May 23rd, 2017
Last updated Jul 20th, 2022 - about 3 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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