Provider Demographics
NPI:1548486335
Name:CARAWAN, TIMOTHY GRAY (DDS)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:GRAY
Last Name:CARAWAN
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 1:873 PRESCOTT RD
Mailing Address - Street 2:
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28560-5915
Mailing Address - Country:US
Mailing Address - Phone:252-745-4578
Mailing Address - Fax:252-745-8251
Practice Address - Street 1:48 HALLS CREEK RD
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28560-5766
Practice Address - Country:US
Practice Address - Phone:252-745-4578
Practice Address - Fax:252-745-8251
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC43281223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice