Provider Demographics
NPI:1821197682
Name:TARR, DANIEL EDWARD (DDS)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:EDWARD
Last Name:TARR
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10032 S SHERIDAN RD
Mailing Address - Street 2:STE. F
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-6295
Mailing Address - Country:US
Mailing Address - Phone:918-298-5544
Mailing Address - Fax:
Practice Address - Street 1:10032 S SHERIDAN RD
Practice Address - Street 2:STE. F
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133-6295
Practice Address - Country:US
Practice Address - Phone:918-298-5544
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK40761223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice