Provider Demographics
NPI:1346388360
Name:CARUS DENTAL, PC
Entity Type:Organization
Organization Name:CARUS DENTAL, PC
Other - Org Name:LONGHORN DENTAL
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:BATES
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:512-371-1222
Mailing Address - Street 1:PO BOX 505073
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63150-5073
Mailing Address - Country:US
Mailing Address - Phone:512-371-1222
Mailing Address - Fax:512-371-3914
Practice Address - Street 1:7517 CAMERON RD
Practice Address - Street 2:SUITE 107
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78752-2057
Practice Address - Country:US
Practice Address - Phone:512-371-1222
Practice Address - Fax:512-371-3914
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-02
Last Update Date:2021-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty