Provider Demographics
NPI:1598972556
Name:CARROLL, DON E JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:DON
Middle Name:E
Last Name:CARROLL
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:W 27TH STREET
Mailing Address - Street 2:SUITE 140
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77008-1435
Mailing Address - Country:US
Mailing Address - Phone:713-864-5443
Mailing Address - Fax:
Practice Address - Street 1:1740 W 27TH ST
Practice Address - Street 2:SUITE 140
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008-1440
Practice Address - Country:US
Practice Address - Phone:713-864-5443
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9768122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist