Provider Demographics
NPI:1760590574
Name:KOLODNY, CARTER LEIGH (DDS)
Entity Type:Individual
Prefix:DR
First Name:CARTER
Middle Name:LEIGH
Last Name:KOLODNY
Suffix:
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 1:1808 S BOWEN ROAD
Mailing Address - Street 2:SUITE C
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76013-3354
Mailing Address - Country:US
Mailing Address - Phone:817-265-7228
Mailing Address - Fax:817-275-8585
Practice Address - Street 1:1808 S BOWEN ROAD
Practice Address - Street 2:SUITE C
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76013-3354
Practice Address - Country:US
Practice Address - Phone:817-265-7228
Practice Address - Fax:817-275-8585
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXTX119071223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice