Individual
DR. CHUCK CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3110 SAWTELLE BLVD APT 207, LOS ANGELES, CA 90066-1432
(949) 280-2424
Mailing address
3110 SAWTELLE BLVD APT 207, LOS ANGELES, CA 90066-1432
(949) 280-2424
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
63104
CA
Other
Enumeration date
03/28/2014
Last updated
03/28/2014
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