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NPI Code Detail

MEDICARE: CAROLYN DALE DENTON D.O.

MEDICARE: CAROLYN DALE DENTON D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianL5302TX

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11F5097OTHERTXMEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1447344635
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAROLYN DALE DENTON D.O.
Provider Business Mailing Address
First Line : 508 N RIEDEL ST
Second Line :
City : YORKTOWN
State : TX
Zip : 78164-1810
Country : US
Telephone Number : 361-564-9230
Fax Number : 361-564-9246
Provider Business Practice Location Address
First Line : 508 N RIEDEL ST
Second Line :
City : YORKTOWN
State : TX
Zip : 78164-1810
Country : US
Telephone Number : 361-564-9230
Fax Number : 361-564-9246
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/03/2006
Last Update Date : 03/07/2023

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Directions to “ CAROLYN DALE DENTON D.O.” Practice Location

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