Individual
JONATHAN ERIC CARLTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
8917 FARGO ROAD, SUITE C, RICHMOND, VA 23229
(804) 740-5015
(804) 740-4840
Mailing address
8917 FARGO ROAD, SUITE C, RICHMOND, VA 23229
(804) 740-5015
(804) 740-4840
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
0438000004
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
452896
ANTHEM
VA
Enumeration date
07/24/2006
Last updated
07/08/2007
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