Search › Minnesota › 122300000X
Tyler Koivisto, DDS
NPI 1588002430 · on the registry since 2013 · sole proprietor
Practice
- Address
- 1430 Highway 96
White Bear Lake, MN 55110 - Phone
- (651) 426-9502
- Fax
- (651) 653-2158
- Clinicians at this address
- 7
Registry record
- Primary taxonomy
- 122300000X
122300000X
- Licence states on file
- MN
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2022-07-21
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Minnesota