Provider Demographics
NPI:1083130348
Name:CS DENTAL, PLLC
Entity Type:Organization
Organization Name:CS DENTAL, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:CARROLL
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:502-417-3025
Mailing Address - Street 1:181 HIGHWAY 44 E STE 2
Mailing Address - Street 2:
Mailing Address - City:SHEPHERDSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40165-6081
Mailing Address - Country:US
Mailing Address - Phone:502-543-3054
Mailing Address - Fax:
Practice Address - Street 1:181 HIGHWAY 44 E STE 2
Practice Address - Street 2:
Practice Address - City:SHEPHERDSVILLE
Practice Address - State:KY
Practice Address - Zip Code:40165-6081
Practice Address - Country:US
Practice Address - Phone:502-543-3054
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental