Provider Demographics
NPI:1649288069
Name:CARROW AND CHAPEL DENTISTRY PARTNERSHIP
Entity type:Organization
Organization Name:CARROW AND CHAPEL DENTISTRY PARTNERSHIP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCIAL COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARSHA
Authorized Official - Middle Name:A
Authorized Official - Last Name:COTTINGHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-465-7777
Mailing Address - Street 1:4113 HUMBERT RD
Mailing Address - Street 2:
Mailing Address - City:ALTON
Mailing Address - State:IL
Mailing Address - Zip Code:62002-7116
Mailing Address - Country:US
Mailing Address - Phone:618-465-7777
Mailing Address - Fax:618-465-7787
Practice Address - Street 1:4113 HUMBERT RD
Practice Address - Street 2:
Practice Address - City:ALTON
Practice Address - State:IL
Practice Address - Zip Code:62002-7116
Practice Address - Country:US
Practice Address - Phone:618-465-7777
Practice Address - Fax:618-465-7787
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-03
Last Update Date:2011-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty