Organization
CHRISTOPHER E CARROLL
Active
Other names
Pediatric Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRISTOPHER E CARROLL D.M.D. (OWNER)
(507) 452-1543
Entity
Organization
Contact information
Practice address
150 E 4TH ST, WINONA, MN 55987-3512
(507) 452-1543
(507) 452-6874
Mailing address
150 E 4TH ST, WINONA, MN 55987-3512
(507) 452-1543
(507) 452-6874
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
8405
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33461700
—
WI
01
—
4822990
MN TAX ID
MN
Enumeration date
04/10/2007
Last updated
08/22/2020
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