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Individual
WESLEY D. CARLISLE
Active
Individual
WESLEY D. CARLISLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, DMD
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
7256
LA
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
302556
LA
Other
Enumeration date
04/28/2015
Last updated
08/19/2021
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