Individual
DR. JASON J CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
1301 N ALPINE RD, ROCKFORD, IL 61107-2262
(815) 397-4280
(815) 484-2436
Mailing address
1301 N ALPINE RD, ROCKFORD, IL 61107-2262
(815) 397-4280
(815) 484-2436
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019030301
IL
Other
Enumeration date
07/17/2015
Last updated
07/17/2015
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