=====================================================
General NPI Number Information
=====================================================
NPI Number | 1437230240
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | GEORGE CARR DDS & ASSOCIATES PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/18/2006
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2072 E SOUTHERN AVE SUITE A-103
-----------------------------------------------------
City | TEMPE
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85282
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 480-756-0194
-----------------------------------------------------
Fax | 480-345-6100
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2072 E SOUTHERN AVE SUITE A-103
-----------------------------------------------------
City | TEMPE
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85282
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 480-756-0194
-----------------------------------------------------
Fax | 480-345-6100
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MEMBER DDS
-----------------------------------------------------
Name | GEORGE A CARR JR.
-----------------------------------------------------
Credential | DDS
-----------------------------------------------------
Telephone | 480-756-0194
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 122300000X
-----------------------------------------------------
Taxonomy Name | Dentist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------