Individual
TIMOTHY ARNOLD CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1100 WILFORD HALL LOOP, JBSA LACKLAND, TX 78236-5638
(210) 292-9199
Mailing address
PSC 9 BOX 1653, APO, AE 09123-0017
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
2402
MT
1223E0200X
Endodontics
Primary
2402
MT
Other
Enumeration date
03/22/2010
Last updated
09/06/2023
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