Provider Demographics
NPI:1215097183
Name:AGARWAL, TARUN (DDS)
Entity type:Individual
Prefix:DR
First Name:TARUN
Middle Name:
Last Name:AGARWAL
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 1:8304 CREEDMOOR RD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27613-1697
Mailing Address - Country:US
Mailing Address - Phone:919-870-7645
Mailing Address - Fax:919-870-8931
Practice Address - Street 1:8304 CREEDMOOR RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27613-1697
Practice Address - Country:US
Practice Address - Phone:919-870-7645
Practice Address - Fax:919-870-8931
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2012-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6949122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist