Carson Family Dentistry, Prof LLC

NPI #1598011561 in Springfield, South Dakota

Provider Information

NPI Number: 1598011561
Entity Type: Organization
Organization Name: Carson Family Dentistry, Prof LLC
Primary Specialty: Clinic/Center - Dental
Enumeration Date: Jul 27, 2012
Last Updated: Jul 27, 2012

Practice Location

Address: 707 CHESTNUT ST
Address 2: BOX 567
City: Springfield
State: South Dakota
ZIP Code: 57062
Phone: (605) 369-2226

Authorized Official

Name: DR. CL;ARENCE NOLAN CARSON III, DDS
Title: OWNER, DENTIST
Phone: (605) 369-2226

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Dental — Dental	261QD0000X	Primary

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