Individual
DR. CARL JOSEPH TYREE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
12007389A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100208100A
—
IN
05
—
100208100B
—
IN
Enumeration date
10/10/2006
Last updated
09/01/2022
Update your record
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