=====================================================
General NPI Number Information
=====================================================
NPI Number | 1285538041
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CHRISTOPHER S CARROLL DDS PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/06/2026
-----------------------------------------------------
Last Update Date | 10/06/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 701 N RIVER ST
-----------------------------------------------------
City | SPOONER
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 54801-1311
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 715-635-8282
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2821 27 1/8 ST
-----------------------------------------------------
City | BIRCHWOOD
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 54817-2038
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 715-635-8282
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER, DENTIST
-----------------------------------------------------
Name | CHRISTOPHER CARROLL
-----------------------------------------------------
Credential | DDS
-----------------------------------------------------
Telephone | 715-635-8282
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223G0001X
-----------------------------------------------------
Taxonomy Name | General Practice Dentistry
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | NULL
-----------------------------------------------------