Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 18030 | MA |
NPI | 1659469724 |
---|---|
Provider Name | Dr. Michael John Carino |
First Address | Washington, DC 20008-4026 |
Second Address | Falls Church, VA 22041-3215 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2006 |
Last Update Date | 08/07/2007 |