Individual
DR. CARL JOSEPH TYREE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2100 45TH ST, HIGHLAND, IN 46322-3742
(219) 924-4411
(219) 924-2314
Mailing address
2100 45TH ST, HIGHLAND, IN 46322-3742
(219) 924-4411
(219) 924-2314
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
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