Provenzano, Carl Ross

Provenzano, Carl Ross is an individual health care provider with primary practice located at 625 19Th St S , Birmingham AL 35233-1900. He recently has 3 registered licenses in different health care specialties including Dental Providers / General Practice, Dental Providers / Oral and Maxillofacial Surgery, Student, Health Care / Student in an Organized Health Care Education/Training Program. Dental Providers / General Practice is his primary health care specialty. Provenzano, Carl Ross can be contacted via phone (205) 934-4507.

Contact Information

Primary practice address
625 19Th St S Birmingham AL 35233-1900
Phone: (205) 934-4507
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 41386 Texas
Dental Providers / General Practice 1223G0001X D12166 Oregon
Dental Providers / General Practice 1223G0001X DS045261 Pennsylvania
Dental Providers / General Practice 1223G0001X 12799 Tennessee
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X D-6826-C1 Alabama
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Dental Providers / General Practice 1223G0001X D-6826-C1 Alabama

Profile Details

NPI number 1548895543
LBN Legal business name Provenzano, Carl Ross
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 10th, 2020
Last updated Aug 25th, 2025 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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