Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | 26602 | CA |
NPI | 1013180439 |
---|---|
Provider Name | Dr. Dana Alan Carlton |
First Address | Westlake Village, CA 91362-3447 |
Second Address | Westlake Village, CA 91362-3447 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/04/2008 |
Last Update Date | 07/04/2008 |