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General NPI Number Information
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NPI Number | 1356204911
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Entity Type | Organization
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Legal Business Name | CARTHAGE FAMILY DENTAL LLC
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Dates
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Enumeration Date | 12/09/2025
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Last Update Date | 12/09/2025
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Provider Practice Location Address
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Address Line | 2337 FAIRLAWN DR STE B
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City | CARTHAGE
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State | MO
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Zip | 64836-3515
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Country | US
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Telephone | 417-781-2900
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Fax |
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Provider Business Mailing Address
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Address Line | 4402 E 32ND ST STE B
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City | JOPLIN
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State | MO
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Zip | 64804-4453
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Country | US
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Telephone | 417-781-2900
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. CONNER PAUSTIAN
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Credential | DDS
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Telephone | 417-781-2900
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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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