DR. CLARK M CARROLL DMDPC NPI 1669595880

NPI Information

NPI: 1669595880
Provider Name: DR. CLARK M CARROLL, DMD,PC
Classification: Dentist - 1223G0001X
Specialization: General Practice
Entity Type: Individual
Address: 750 MEDICAL CENTER DR
EASTMAN, GA
ZIP 31023
Phone: (478) 374-7184

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NPI Details

DR. Clark M Carroll, DMD,PC is a general practice dentist in Eastman, GA. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. DR. Clark M Carroll, DMD,PC NPI is 1669595880. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

750 MEDICAL CENTER DR
EASTMAN, GA
ZIP 31023-736
Phone: (478) 374-7184
Fax: (478) 374-4238

The enumeration date for this NPI number is 4/10/2007 and was last updated on 7/9/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	1223G0001X	Dentist	General Practice	8260	GEORGIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	00044976A	MEDICAID	GEORGIA
2	100952	MEDICAID	GEORGIA
3	9180290	MEDICAID	GEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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