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General NPI Number Information
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NPI Number | 1073110888
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Entity Type | Organization
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Legal Business Name | CAROUSEL DENTAL PLLC
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Dates
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Enumeration Date | 10/05/2020
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Last Update Date | 10/05/2020
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Provider Practice Location Address
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Address Line | 2315 GUS THOMASSON RD
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City | DALLAS
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State | TX
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Zip | 75228-3004
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Country | US
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Telephone | 916-897-6682
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Fax |
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Provider Business Mailing Address
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Address Line | 7146 GRAND OAKS RD
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City | DALLAS
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State | TX
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Zip | 75230-4223
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JOHN MEEKAY
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Credential | DMD
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Telephone | 916-897-6682
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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