Individual
DR. CLARENCE NOLAN CARSON III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
707 CHESTNUT ST, SPRINGFIELD, SD 57062
(605) 369-2226
Mailing address
707 CHESTNUT ST, PO BOX 567, SPRINGFIELD, SD 57062
(605) 369-2226
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
M894
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
46046213100
—
NE
Enumeration date
10/04/2006
Last updated
07/17/2012
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