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Individual

DOUGLAS M CARLSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
1000 VALE TERRACE DR, VISTA, CA 92084-5218
(760) 631-5000
(760) 414-3892
Mailing address
1000 VALE TERRACE DR, VISTA, CA 92084-5218
(760) 631-5000
(760) 414-3892

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
26601
CA

Other

Enumeration date
04/18/2008
Last updated
05/01/2009
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