Provider Demographics
NPI:1962435867
Name:CARLTON, MICHELLE DUMILLER (DDS)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:DUMILLER
Last Name:CARLTON
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 1:348 VETERANS BLVD
Mailing Address - Street 2:
Mailing Address - City:DENHAM SPRINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70726-4721
Mailing Address - Country:US
Mailing Address - Phone:225-664-9699
Mailing Address - Fax:225-664-9698
Practice Address - Street 1:348 VETERANS BLVD
Practice Address - Street 2:
Practice Address - City:DENHAM SPRINGS
Practice Address - State:LA
Practice Address - Zip Code:70726-4721
Practice Address - Country:US
Practice Address - Phone:225-664-9699
Practice Address - Fax:225-664-9698
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA53201223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics