Individual
DAVID CHASE CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
777 N 500 W # 201, PROVO, UT 84601-1541
(801) 374-8244
Mailing address
1026 COVENTRY CIR, OREM, UT 84097-4700
(801) 885-6460
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D11311
OR
Other
Enumeration date
09/08/2020
Last updated
12/18/2021
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