Provider Demographics
NPI:1376710509
Name:CARSON, ERIN ELIZABETH (DDS)
Entity type:Individual
Prefix:DR
First Name:ERIN
Middle Name:ELIZABETH
Last Name:CARSON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 SIERRA GATE PLZ
Mailing Address - Street 2:SUITE 170
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95678-6645
Mailing Address - Country:US
Mailing Address - Phone:916-783-9102
Mailing Address - Fax:
Practice Address - Street 1:10 SIERRA GATE PLZ
Practice Address - Street 2:SUITE 170
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95678-6645
Practice Address - Country:US
Practice Address - Phone:916-783-9102
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-16
Last Update Date:2008-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA55466122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist