Provider Demographics
NPI:1326365115
Name:LEVITT, CARL PAUL (DDS)
Entity Type:Individual
Prefix:DR
First Name:CARL
Middle Name:PAUL
Last Name:LEVITT
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 1:1025 ROSE CREEK DRIVE
Mailing Address - Street 2:SUITE 260
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30189
Mailing Address - Country:US
Mailing Address - Phone:770-516-6100
Mailing Address - Fax:770-516-6100
Practice Address - Street 1:1025 ROSE CREEK DRIVE
Practice Address - Street 2:SUITE 260
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30189
Practice Address - Country:US
Practice Address - Phone:770-516-6100
Practice Address - Fax:770-516-6100
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-03
Last Update Date:2016-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA8363122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist