Carlson, Mark David
Carlson, Mark David is an individual health care provider with primary practice located at 1550 South Union Avenue Suite 250, Tacoma WA 98405-1946. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as his primary health care specialty. Carlson, Mark David can be contacted via phone (253) 572-4601.Contact Information
Primary practice address
1550 South Union Avenue Suite 250
Tacoma WA 98405-1946
Phone: (253) 572-4601
Fax: (253) 572-4769
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | DE00005551 | Washington |
Profile Details
| NPI number | 1083670780 |
|---|---|
| LBN Legal business name | Carlson, Mark David |
| Credentials | MS DDS |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 22nd, 2006 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1083670780 | NPPES |
| Washington | MEDICAID | 5005491 |
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