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NPI Code Detail

MEDICARE: DR. CARTER LEROY HALLMARK D.D.S.

MEDICARE: DR. CARTER LEROY HALLMARK D.D.S.
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
11223G0001XGeneral Practice Dentistry10471TX

General Provider Information

NPI Number : 1417952763
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CARTER LEROY HALLMARK D.D.S.
Provider Business Mailing Address
First Line : 1111 S MACARTHUR BLVD
Second Line :
City : IRVING
State : TX
Zip : 75060-3827
Country : US
Telephone Number : 972-790-4568
Fax Number : 972-259-2809
Provider Business Practice Location Address
First Line : 1111 S MACARTHUR BLVD
Second Line :
City : IRVING
State : TX
Zip : 75060-3827
Country : US
Telephone Number : 972-790-4568
Fax Number : 972-259-2809
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/14/2005
Last Update Date : 07/08/2007

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