Provider Demographics
NPI:1346337359
Name:CARSON, DANIEL STEVEN JR (DMD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:STEVEN
Last Name:CARSON
Suffix:JR
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63 W BLUFF DR
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-7547
Mailing Address - Country:US
Mailing Address - Phone:843-860-0938
Mailing Address - Fax:
Practice Address - Street 1:6602 ABERCORN ST
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-5848
Practice Address - Country:US
Practice Address - Phone:912-354-3444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2015-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC41301223S0112X
GADN0145551223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery