Provider Demographics
NPI:1063305126
Name:CARLISLE DENTAL CARE PC
Entity type:Organization
Organization Name:CARLISLE DENTAL CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PRUTHVISHKUMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:304-707-7254
Mailing Address - Street 1:123 NOVEMBER DR APT 1
Mailing Address - Street 2:
Mailing Address - City:CAMP HILL
Mailing Address - State:PA
Mailing Address - Zip Code:17011-5049
Mailing Address - Country:US
Mailing Address - Phone:304-707-7254
Mailing Address - Fax:
Practice Address - Street 1:850 WALNUT BOTTOM RD STE 303
Practice Address - Street 2:
Practice Address - City:CARLISLE
Practice Address - State:PA
Practice Address - Zip Code:17013-3615
Practice Address - Country:US
Practice Address - Phone:717-243-5434
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-29
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty