Provider Demographics
NPI:1780322743
Name:CASH, CAROLYN NICOLE (DDS)
Entity type:Individual
Prefix:DR
First Name:CAROLYN
Middle Name:NICOLE
Last Name:CASH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1316 ARMAND DR APT 103
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38103-8953
Mailing Address - Country:US
Mailing Address - Phone:318-453-2712
Mailing Address - Fax:
Practice Address - Street 1:3809 WHITES FERRY RD
Practice Address - Street 2:
Practice Address - City:WEST MONROE
Practice Address - State:LA
Practice Address - Zip Code:71291-2006
Practice Address - Country:US
Practice Address - Phone:318-396-6204
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-20
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA000001223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry