Jean Judy Carlson, D.D.S.

Individual provider Active NPI General Practice Dentistry · Cambridge, MD

NPI 1497815468 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1497815468
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
8202 (MD)
Practice address
609 Locust St
Cambridge, MD 21613-1705
Phone
(410) 228-7111
Fax
(410) 228-9497
NPI assigned
Dec 11, 2006
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
8202MDMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 8202 MD Yes

Addresses

Primary practice location

609 Locust St
Cambridge, MD 21613-1705

Mailing address

609 Locust St
Cambridge, MD 21613-1705
Phone (410) 228-7111

Other providers in Cambridge, MD

All providers in Cambridge, MD · General Practice Dentistry in Maryland

Sources for this page

Verify at the official NPI Registry.