Individual
MR. NATHAN ELLIOT CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D
Contact information
Practice address
3156 KENSINGTON AVE, PHILADELPHIA, PA 19134-2400
(215) 831-1100
(215) 807-8951
Mailing address
3156 KENSINGTON AVE, PHILADELPHIA, PA 19134-2400
(215) 831-1100
(215) 807-8951
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS031595L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DS031595L
PA DENTIST LICENSE
PA
Enumeration date
07/06/2007
Last updated
01/14/2008
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