Healthcare Provider Details

I. General information

NPI: 1285538041
Provider Name (Legal Business Name): CHRISTOPHER S CARROLL DDS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 N RIVER ST
SPOONER WI
54801-1311
US

IV. Provider business mailing address

2821 27 1/8 ST
BIRCHWOOD WI
54817-2038
US

V. Phone/Fax

Practice location:
  • Phone: 715-635-8282
  • Fax:
Mailing address:
  • Phone: 715-635-8282
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number StateNULL

VIII. Authorized Official

Name: CHRISTOPHER CARROLL
Title or Position: OWNER, DENTIST
Credential: DDS
Phone: 715-635-8282