ASA DERRICK CARSON

CHICAGO, IL
NPI1326577362
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1223G0001X Dentist, General Practice
(Licence: IL  019031149)
Enumeration Date2017-06-05
Last Update Date2017-06-05
Business Address
ASA DERRICK CARSON
25 E WASHINGTON ST
CHICAGO, IL 60602-1708
Phone number: 312-782-8862
Mailing Address
ASA DERRICK CARSON
1517 W TAYLOR ST FL 1
CHICAGO, IL 60607-4015
Phone number:
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