Individual
DR. CARLY CARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
15 ALDEN ST., SUITE #6, CRANFORD, NJ 07016
(908) 276-1669
(908) 276-1631
Mailing address
15 ALDEN ST., SUITE 6, CRANFORD, NJ 07016
(908) 276-1669
(908) 276-1631
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
22DI02327700
NJ
1223G0001X
General Practice Dentistry
Primary
22DI02327700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22DI02327700
DENTAL LIC
NJ
01
—
D08968400
CDS
—
01
—
FC0002648
CDS
NJ
Enumeration date
04/24/2007
Last updated
08/12/2013
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