Provider Demographics
NPI:1558412890
Name:PITTMAN, CARL EUGENE (DDS)
Entity Type:Individual
Prefix:DR
First Name:CARL
Middle Name:EUGENE
Last Name:PITTMAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9316 LOUETTA RD
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-6520
Mailing Address - Country:US
Mailing Address - Phone:281-376-2706
Mailing Address - Fax:281-357-1847
Practice Address - Street 1:9316 LOUETTA RD
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-6520
Practice Address - Country:US
Practice Address - Phone:281-376-2706
Practice Address - Fax:281-357-1847
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX180431223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry