Provider Demographics
NPI:1912127747
Name:J THOMAS CARROLL DDS PC
Entity Type:Organization
Organization Name:J THOMAS CARROLL DDS PC
Other - Org Name:TODAY'S DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:CARROLL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS,PC
Authorized Official - Phone:409-762-8443
Mailing Address - Street 1:1801 BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77550-4912
Mailing Address - Country:US
Mailing Address - Phone:409-762-8443
Mailing Address - Fax:409-762-0036
Practice Address - Street 1:1801 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77550-4912
Practice Address - Country:US
Practice Address - Phone:409-762-8443
Practice Address - Fax:409-762-0036
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-26
Last Update Date:2016-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX142891223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty