Provider Demographics
NPI:1376659227
Name:GEE, CARROLL MILLARD JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:CARROLL
Middle Name:MILLARD
Last Name:GEE
Suffix:JR
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:PO BOX 688
Mailing Address - Street 2:
Mailing Address - City:KENBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:23944-0688
Mailing Address - Country:US
Mailing Address - Phone:434-676-3067
Mailing Address - Fax:434-676-3280
Practice Address - Street 1:121 FLAT ROCK RD.
Practice Address - Street 2:
Practice Address - City:KENBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:23944-0688
Practice Address - Country:US
Practice Address - Phone:434-676-3067
Practice Address - Fax:434-676-3280
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010052261223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA116862OtherANTHEM
VA651432OtherUNITED CONCORDIA