Provider Demographics
NPI:1255420535
Name:G.CARRIER D.M.D., S. WALSH JR.D.D.S., C. MARCO D.M.D. INC.
Entity type:Organization
Organization Name:G.CARRIER D.M.D., S. WALSH JR.D.D.S., C. MARCO D.M.D. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STANLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:WALSH
Authorized Official - Suffix:JR
Authorized Official - Credentials:DMD
Authorized Official - Phone:508-995-5105
Mailing Address - Street 1:559 ASHLEY BLVD
Mailing Address - Street 2:
Mailing Address - City:NEW BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02745-5403
Mailing Address - Country:US
Mailing Address - Phone:508-995-5105
Mailing Address - Fax:508-998-2213
Practice Address - Street 1:559 ASHLEY BLVD
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02745-5403
Practice Address - Country:US
Practice Address - Phone:508-995-5105
Practice Address - Fax:508-998-2213
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA129691223G0001X
MA115641223G0001X
MA171611223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty