Mark Landis Carr, DDS

Individual provider Active NPI General Practice Dentistry · Cameron, MO

NPI 1053590919 · NPPES record last updated Nov 6, 2007

Key facts

NPI
1053590919
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
14415 (MO)
Practice address
312 N Walnut
Cameron, MO 64429-1825
Phone
(816) 632-5812
Fax
(816) 632-8879
NPI assigned
Oct 29, 2007
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
14415MOMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 14415 MO Yes

Addresses

Primary practice location

312 N Walnut
Cameron, MO 64429-1825

Mailing address

312 N Walnut
Cameron, MO 64429-1825
Phone (816) 632-5812

Other providers in Cameron, MO

All providers in Cameron, MO · General Practice Dentistry in Missouri

Sources for this page

Verify at the official NPI Registry.