Provider Demographics
NPI:1386780567
Name:CARWILE, DAVID SCOTT (DDS)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:SCOTT
Last Name:CARWILE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18438 HIGHWAY 105 W
Mailing Address - Street 2:SUITE D
Mailing Address - City:MONTGOMERY
Mailing Address - State:TX
Mailing Address - Zip Code:77356-6045
Mailing Address - Country:US
Mailing Address - Phone:936-582-6677
Mailing Address - Fax:936-582-4590
Practice Address - Street 1:18438 HIGHWAY 105 W
Practice Address - Street 2:SUITE D
Practice Address - City:MONTGOMERY
Practice Address - State:TX
Practice Address - Zip Code:77356-6045
Practice Address - Country:US
Practice Address - Phone:936-582-6677
Practice Address - Fax:936-582-4590
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX186841223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice