Individual
DOMINIC GORDON CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1851 OAK ST STE A, BAKERSFIELD, CA 93301-3005
(661) 327-7301
Mailing address
1851 OAK ST STE A, BAKERSFIELD, CA 93301-3005
(661) 327-7301
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
105267
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
105267
DENTAL BOARD OF CALIFORNIA
CA
Enumeration date
08/31/2020
Last updated
08/31/2020
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