Provider Demographics
NPI:1699867838
Name:CARANO, DOUGLAS ANTHONY (DDS)
Entity type:Individual
Prefix:MR
First Name:DOUGLAS
Middle Name:ANTHONY
Last Name:CARANO
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 1:7056 HIGHWAY BB
Mailing Address - Street 2:
Mailing Address - City:CEDAR HILL
Mailing Address - State:MO
Mailing Address - Zip Code:63016-2301
Mailing Address - Country:US
Mailing Address - Phone:636-274-0447
Mailing Address - Fax:636-274-7079
Practice Address - Street 1:7056 HIGHWAY BB
Practice Address - Street 2:
Practice Address - City:CEDAR HILL
Practice Address - State:MO
Practice Address - Zip Code:63016-2301
Practice Address - Country:US
Practice Address - Phone:636-274-0447
Practice Address - Fax:636-274-7079
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOMO142041223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice