Provider Demographics
NPI:1235976887
Name:MCKINNEY, TYLER CHRISTIAN (DDS)
Entity type:Individual
Prefix:DR
First Name:TYLER
Middle Name:CHRISTIAN
Last Name:MCKINNEY
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 1:151 BISHOP MURPHY DR
Mailing Address - Street 2:
Mailing Address - City:FROSTBURG
Mailing Address - State:MD
Mailing Address - Zip Code:21532-1329
Mailing Address - Country:US
Mailing Address - Phone:301-689-6780
Mailing Address - Fax:
Practice Address - Street 1:151 BISHOP MURPHY DR
Practice Address - Street 2:
Practice Address - City:FROSTBURG
Practice Address - State:MD
Practice Address - Zip Code:21532-1329
Practice Address - Country:US
Practice Address - Phone:301-689-6780
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-11
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD181921223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice