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NPI Code Detail

MEDICARE: DR. PATRICK MICHAEL CARROLL DMD

MEDICARE:  DR. PATRICK MICHAEL CARROLL  DMD
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 Dentistry5551KY

General Provider Information

NPI Number : 1558472472
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PATRICK MICHAEL CARROLL DMD
Provider Business Mailing Address
First Line : 7513 NEW LAGRANGE RD
Second Line :
City : LOUISVILLE
State : KY
Zip : 40222-4859
Country : US
Telephone Number : 502-423-7868
Fax Number : 502-327-7446
Provider Business Practice Location Address
First Line : 7513 NEW LAGRANGE RD
Second Line :
City : LOUISVILLE
State : KY
Zip : 40222-4859
Country : US
Telephone Number : 502-423-7868
Fax Number : 502-327-7446
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2006
Last Update Date : 07/08/2007

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Directions to “ DR. PATRICK MICHAEL CARROLL DMD” Practice Location

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