| Carson Family Dentistry, Prof Llc | |
|
707 Chestnut St Box 567 Springfield SD 57062 | |
| (605) 369-2226 | |
| Not Available |
| Full Name | Carson Family Dentistry, Prof Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 707 Chestnut St, Springfield, South Dakota |
| Authorized Official Name and Position | Cl;arence Nolan Carson (OWNER, DENTIST) |
| Authorized Official Contact | 6053692226 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Carson Family Dentistry, Prof Llc 707 Chestnut St Box 567 Springfield SD 57062 Ph: (605) 369-2226 | Carson Family Dentistry, Prof Llc 707 Chestnut St Box 567 Springfield SD 57062 Ph: (605) 369-2226 |
| NPI Number | 1598011561 |
|---|---|
| Provider Enumeration Date | 07/27/2012 |
| Last Update Date | 07/27/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598011561 | NPI | - | NPPES |
| 1528154234 | Medicaid | NE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | M894 (South Dakota) | Primary |