Individual
CASEY CARBONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
350 N MOUNTAIN AVE, MONROVIA, CA 91016-2439
(626) 434-0484
Mailing address
350 N MOUNTAIN AVE, MONROVIA, CA 91016-2439
(626) 434-0484
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
25950
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25950
REGISTERED DENTAL HYGIENIST
CA
Enumeration date
06/29/2012
Last updated
07/01/2012
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