Provider Demographics
NPI:1295823714
Name:ELGIN FAMILY DENTAL, INC.
Entity Type:Organization
Organization Name:ELGIN FAMILY DENTAL, INC.
Other - Org Name:CARL F. HERRING, DDS, INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CARL
Authorized Official - Middle Name:
Authorized Official - Last Name:HERRING
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:512-285-3322
Mailing Address - Street 1:306 N HIGHWAY 95
Mailing Address - Street 2:P.O. BOX 32
Mailing Address - City:ELGIN
Mailing Address - State:TX
Mailing Address - Zip Code:78621-1519
Mailing Address - Country:US
Mailing Address - Phone:512-285-3322
Mailing Address - Fax:512-285-3447
Practice Address - Street 1:306 N HIGHWAY 95
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:TX
Practice Address - Zip Code:78621-1519
Practice Address - Country:US
Practice Address - Phone:512-285-3322
Practice Address - Fax:512-285-3447
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-10
Last Update Date:2016-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXTX114961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty