Provider Demographics
NPI:1073676359
Name:PLYLER, CARL S (DDS)
Entity Type:Individual
Prefix:DR
First Name:CARL
Middle Name:S
Last Name:PLYLER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 ELM ST
Mailing Address - Street 2:PO BOX 4
Mailing Address - City:GLENWOOD
Mailing Address - State:AR
Mailing Address - Zip Code:71943
Mailing Address - Country:US
Mailing Address - Phone:870-356-3920
Mailing Address - Fax:870-356-4163
Practice Address - Street 1:119 ELM ST
Practice Address - Street 2:
Practice Address - City:GLENWOOD
Practice Address - State:AR
Practice Address - Zip Code:71943
Practice Address - Country:US
Practice Address - Phone:870-356-3920
Practice Address - Fax:870-356-4163
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR26901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice