NPI 1104805431 · live from the CMS NPI Registry
La Shun La Rue Carroll, D.D.S.
Dentist, General Practice in Wakefield, RI. National Provider Identifier 1104805431, active.
NPI record
| NPI | 1104805431 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dentist, General Practice 1223G0001X |
| Practice location | 1 River St, Wakefield, RI 02879 |
| Practice phone | 401-783-5646 |
| Enumerated | January 13, 2006 |
| Last updated | January 26, 2015 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dentist, General Practice primary | 1223G0001X | DEN03155 (RI) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.