Provider Demographics
NPI:1306947304
Name:CARR, WILLIAM B
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:B
Last Name:CARR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8801 N. MERIDIAN STREET
Mailing Address - Street 2:SUITE 309
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-5316
Mailing Address - Country:US
Mailing Address - Phone:317-844-8085
Mailing Address - Fax:317-844-9263
Practice Address - Street 1:8801 N MERIDIAN ST
Practice Address - Street 2:SUITE 309
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-2396
Practice Address - Country:US
Practice Address - Phone:317-844-8085
Practice Address - Fax:317-844-9263
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12006691A1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice