Carson Van Etta, DMD

NPI #1154085470 in Fort Bliss, Texas

Provider Information

NPI Number: 1154085470
Entity Type: Individual
Name: Carson Van Etta, DMD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist
Credential: DMD
Enumeration Date: Oct 22, 2021
Last Updated: Oct 22, 2021

Practice Location

Address: 18511 HIGHLANDER MEDICS ST
City: Fort Bliss
State: Texas
ZIP Code: 79918
Phone: (337) 531-2603

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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