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General NPI Number Information
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NPI Number | 1760680326
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Entity Type | Organization
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Legal Business Name | CARRATOLA & MERRILL, DDS, LLC
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Dates
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Enumeration Date | 07/05/2007
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Last Update Date | 11/20/2007
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Provider Practice Location Address
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Address Line | 63 E MAIN ST
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City | NEW LONDON
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State | OH
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Zip | 44851-1233
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Country | US
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Telephone | 419-929-1544
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Fax | 419-929-0402
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Provider Business Mailing Address
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Address Line | 63 E MAIN ST
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City | NEW LONDON
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State | OH
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Zip | 44851-1233
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Country | US
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Telephone | 419-929-1544
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Fax | 419-929-0402
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Authorized Official
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Title or Position | MANAGING MEMBER-DENTIST
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Name | DR. LOUIS MICHAEL CARRATOLA
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Credential | D.D.S.
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Telephone | 419-929-1544
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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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