Individual
DR. JOHN THOMAS CARSON SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S. M.S.
Contact information
Practice address
10425 FAIR OAKS BLVD, SUITE 102, FAIR OAKS, CA 95628-7559
(916) 965-7444
(916) 965-9372
Mailing address
10425 FAIR OAKS BLVD, SUITE 102, FAIR OAKS, CA 95628-7559
(916) 965-7444
(916) 965-9372
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
32042
CA
Other
Enumeration date
01/08/2007
Last updated
07/08/2007
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