MEDICARE: DR. COURTNEY BETH CARR DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	22737	TX
2	1223P0221X	Pediatric Dentistry	22737	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134251515
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. COURTNEY BETH CARR DDS

Provider Business Mailing Address
First Line	:	1100 KING MARK DR
Second Line	:
City	:	LEWISVILLE
State	:	TX
Zip	:	75056-5786
Country	:	US
Telephone Number	:	214-228-3365
Fax Number	:

Provider Business Practice Location Address
First Line	:	6225 CHAPEL HILL BLVD
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75093-6392
Country	:	US
Telephone Number	:	972-608-4746
Fax Number	:	972-608-4749

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/12/2007
Last Update Date	:	11/30/2011

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