Organization
CARL A. TROUT, DDS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARL ANDREW TROUT DDS (PEDIATRIC DENTIST)
17012321148
Entity
Organization
Contact information
Practice address
2538 UNIVERSITY DR S, SUITE A, FARGO, ND 58103-5714
(170) 123-2114
Mailing address
2538 UNIVERSITY DR S, SUITE A, FARGO, ND 58103-5714
(170) 123-2114
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
2168
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000040116
—
ND
Enumeration date
05/18/2014
Last updated
05/18/2014
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