Provider Demographics
NPI:1598788317
Name:WOODEN, CAROL A (DDS)
Entity Type:Individual
Prefix:DR
First Name:CAROL
Middle Name:A
Last Name:WOODEN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 CHURCH ST SE
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080-3563
Mailing Address - Country:US
Mailing Address - Phone:770-438-2400
Mailing Address - Fax:770-432-5050
Practice Address - Street 1:1300 CHURCH ST SE
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080-3563
Practice Address - Country:US
Practice Address - Phone:770-438-2400
Practice Address - Fax:770-432-5050
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0096091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice