Individual
GEORGE R CARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
1321
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5510958
CHIP
MT
Enumeration date
09/08/2008
Last updated
09/08/2008
Update your record
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