| Randy D Carlson Dmd Adc And Charles L Drury Dds Aegd Apc | |
|
5256 S Mission Rd Suite 1101 Bonsall CA 92003-3614 | |
| (760) 630-5500 | |
| (760) 630-5831 |
| Full Name | Randy D Carlson Dmd Adc And Charles L Drury Dds Aegd Apc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 5256 S Mission Rd, Bonsall, California |
| Authorized Official Name and Position | Randy Dennis Carlson (MANAGING PARTNER) |
| Authorized Official Contact | 7606305500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Randy D Carlson Dmd Adc And Charles L Drury Dds Aegd Apc 5256 S Mission Rd Suite 1101 Bonsall CA 92003-3614 Ph: (760) 630-5500 | Randy D Carlson Dmd Adc And Charles L Drury Dds Aegd Apc 5256 S Mission Rd Suite 1101 Bonsall CA 92003-3614 Ph: (760) 630-5500 |
| NPI Number | 1588969547 |
|---|---|
| Provider Enumeration Date | 01/21/2011 |
| Last Update Date | 01/21/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588969547 | NPI | - | NPPES |
| 34679 | Other | CA | DELTA DENTAL |
| 753898 | Other | CA | UNITED CONCORDIA |
| 48905 | Other | CA | DELTA DENTAL |
| 415674 | Other | CA | UNITED CONCORDIA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 34679 (California) | Primary |
| 1223G0001X | Dentist - General Practice | 48905 (California) | Secondary |