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Individual
DR. CARSON MYLES CRUISE
Active
Individual
DR. CARSON MYLES CRUISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
3799-15
MS
1223P0221X
Pediatric Dentistry
0442000266
VA
1223P0221X
Pediatric Dentistry
6838
LA
1223P0221X
Pediatric Dentistry
Primary
D.0006743-C1
AL
Other
Enumeration date
06/22/2015
Last updated
07/28/2020
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