| NPI | 1184637258 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL F CARLSON Dentist Owner 507-238-1883 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MN 11032) |
| Additional Taxonomies | 122300000X Dentist (Licence: MN 6851) |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2020-08-22 |