Provider Demographics
NPI:1336717784
Name:GIRARD, CARRIE ANNE (RDH)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:ANNE
Last Name:GIRARD
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 1:8607 SWEETBRIAR CT
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34655-2921
Mailing Address - Country:US
Mailing Address - Phone:727-992-4606
Mailing Address - Fax:
Practice Address - Street 1:41324 US HIGHWAY 19 N
Practice Address - Street 2:
Practice Address - City:TARPON SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34689-5111
Practice Address - Country:US
Practice Address - Phone:727-942-4144
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-13
Last Update Date:2021-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDH18512124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist