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Individual
GAURAV TYAGI
Active
Individual
GAURAV TYAGI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
29711
TX
1223G0001X
General Practice Dentistry
6439
OK
1223P0700X
Prosthodontics
29711
TX
Other
Enumeration date
07/24/2012
Last updated
02/12/2025
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