Individual provider · NPI-1

Dr. Tiwalade Abidoye, DDS

Dentist, General Practice · Tyler, TX

NPI number1639701923
StatusActive
Last updated in NPPESOct 22, 2024

Details

NPI
1639701923
Entity type
Individual (NPI-1)
Name
Dr. Tiwalade Abidoye
Credential
DDS
Sex
Female
Sole proprietor
No
Enumeration date
Feb 5, 2020
Certification date
Oct 22, 2024
Last updated
Oct 22, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1223G0001X Dentist, General Practice36272TXYes
1223G0001X Dentist, General PracticeDDS104536CA

Practice location

1932 E Se Loop 323
Tyler, TX 75701-8337

Phone 430-205-8686

Mailing address

430 E Lamar Blvd Ste 102
Arlington, TX 76011-3600

Phone 323-445-3465

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