DR. Tyler J Koivisto, DDS
NPI #1588002430 in White Bear Lake, Minnesota
Provider Information
- NPI Number
- 1588002430
- Entity Type
- Individual
- Name
- DR. Tyler J Koivisto, DDS
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Dentist
- Credential
- DDS
- Enumeration Date
- Jun 12, 2013
- Last Updated
- Jul 21, 2022
Practice Location
- Address
- 1430 HIGHWAY 96
- City
- White Bear Lake
- State
- Minnesota
- ZIP Code
- 55110
- Phone
- (651) 426-9502
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist |
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