Provider Demographics
NPI:1467532192
Name:CARUS DENTAL
Entity Type:Organization
Organization Name:CARUS DENTAL
Other - Org Name:JONES RD
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MALCOLM
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:512-371-1222
Mailing Address - Street 1:7517 CAMERON ROAD
Mailing Address - Street 2:SUITE 107 LONGHORN DENTAL ASSOCIATES PC
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78752
Mailing Address - Country:US
Mailing Address - Phone:512-371-1222
Mailing Address - Fax:512-371-3914
Practice Address - Street 1:13331 JONES RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-3915
Practice Address - Country:US
Practice Address - Phone:281-807-5539
Practice Address - Fax:281-807-1062
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2009-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty