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General NPI Number Information
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NPI Number | 1255420535
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Entity Type | Organization
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Legal Business Name | G.CARRIER D.M.D., S. WALSH JR.D.D.S., C. MARCO D.M.D. INC.
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Dates
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Enumeration Date | 10/12/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 559 ASHLEY BLVD
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City | NEW BEDFORD
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State | MA
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Zip | 02745-5403
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Country | US
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Telephone | 508-995-5105
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Fax | 508-998-2213
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Provider Business Mailing Address
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Address Line | 559 ASHLEY BLVD
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City | NEW BEDFORD
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State | MA
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Zip | 02745-5403
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Country | US
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Telephone | 508-995-5105
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Fax | 508-998-2213
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. STANLEY WALSH JR.
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Credential | D.M.D.
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Telephone | 508-995-5105
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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 | 12969
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 11564
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 17161
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License Number State | MA
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