Individual
KWELI KEENE CARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
7625 MAPLE LAWN BLVD, SUITE 255, FULTON, MD 20759-2565
(301) 604-3636
(301) 604-3600
Mailing address
3954 BALLET WAY, BURTONSVILLE, MD 20866
(301) 476-9527
(301) 604-3600
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12155
MD
Other
Enumeration date
11/29/2006
Last updated
05/14/2010
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