Individual
DR. JOHN RAYMOND CARLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
58 COURT ST, MIDDLEBURY, VT 05753-1419
(802) 388-6344
(802) 388-4103
Mailing address
7 CHIPMAN HTS, MIDDLEBURY, VT 05753-1201
(802) 388-3874
(802) 388-4103
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
016-0000741
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0002436
—
VT
Enumeration date
01/10/2006
Last updated
07/18/2007
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