Organization
ROBERT CARROLL, DDS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT E CARROLL GENERAL DENTIST (OWNER)
(573) 365-6600
Entity
Organization
Contact information
Practice address
2935 BAGNELL DAM BLVD, STE. 102, LAKE OZARK, MO 65049-8661
(573) 365-6600
(573) 365-6470
Mailing address
PO BOX 827, LAKE OZARK, MO 65049-0827
(573) 365-6600
(573) 365-6470
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
13964
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1073532800
TYPE 1 NPI
MO
Enumeration date
06/07/2007
Last updated
08/22/2020
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