Healthcare Provider Details

I. General information

NPI: 1386810752
Provider Name (Legal Business Name): CARUS DENTAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2008
Last Update Date: 05/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4407 BEE CAVE RD STE.C
WEST LAKE HILLS TX
78746-6405
US

IV. Provider business mailing address

7517 CAMERON RD STE. 107
AUSTIN TX
78752-2057
US

V. Phone/Fax

Practice location:
  • Phone: 512-329-5739
  • Fax: 512-347-7524
Mailing address:
  • Phone: 512-371-1222
  • Fax: 512-371-3914

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number
License Number State

VIII. Authorized Official

Name: MALCOLM RAY SCOTT
Title or Position: PRESIDENT
Credential: D.D.S.
Phone: 512-371-1222