Individual
GURBIR PAUL TIWANA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D. M.D. M.S.
Contact information
Practice address
1000 N LINCOLN BLVD # 2000, OKLAHOMA CITY, OK 73104
(405) 271-4955
(405) 271-4525
Mailing address
2745 S I 35 SERVICE RD, MOORE, OK 73160-2715
(405) 261-1002
(405) 493-0995
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
8072
KY
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
F-25350
TX
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
38750
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200506200A
—
IN
05
—
60002995
—
KY
05
—
64084601
—
KY
Enumeration date
09/07/2006
Last updated
08/08/2019
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