Individual
DR. JOHN CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
36 WELLES ST, SUITE 240, GLASTONBURY, CT 06033-2080
(860) 633-2031
Mailing address
36 WELLES ST, SUITE 240, GLASTONBURY, CT 06033-2080
(860) 633-2031
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
008882
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
008882
STATE LICENSE
CT
Enumeration date
03/07/2007
Last updated
07/08/2007
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