MEDICARE: DR. THOMAS LAUGHREN CARROLL DDS

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
1	122300000X	Dentist	7697	GA

General Provider Information

NPI Number	:	1922291012
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS LAUGHREN CARROLL DDS

Provider Business Mailing Address
First Line	:	2993 PIEDMONT RD NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30305-2600
Country	:	US
Telephone Number	:	404-237-9944
Fax Number	:

Provider Business Practice Location Address
First Line	:	2993 PIEDMONT RD NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30305-2600
Country	:	US
Telephone Number	:	404-237-9944
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/22/2007
Last Update Date	:	08/22/2007

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