Provider Demographics
NPI:1871763409
Name:CARRROLL, THOMAS D (DDS)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:D
Last Name:CARRROLL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 N GRAFTON
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:TX
Mailing Address - Zip Code:76446
Mailing Address - Country:US
Mailing Address - Phone:254-445-3494
Mailing Address - Fax:254-445-2885
Practice Address - Street 1:114 N GRAFTON
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:TX
Practice Address - Zip Code:76446
Practice Address - Country:US
Practice Address - Phone:254-445-3494
Practice Address - Fax:254-445-2885
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-11
Last Update Date:2023-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14162122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist