Provider Demographics
NPI:1942549563
Name:ROSS, CARRIE (RDH)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:
Last Name:ROSS
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1380 LITTLE SORRELL DRIVE
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22801-7370
Mailing Address - Country:US
Mailing Address - Phone:540-433-4913
Mailing Address - Fax:540-433-4915
Practice Address - Street 1:1380 LITTLE SORRELL DRIVE
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-7370
Practice Address - Country:US
Practice Address - Phone:540-433-4913
Practice Address - Fax:540-433-4915
Is Sole Proprietor?:No
Enumeration Date:2013-02-01
Last Update Date:2013-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0402205118124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist