| NPI | 1689023129 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID C CARLSON Dentist 701-664-2582 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: ND 1718) |
| Enumeration Date | 2016-06-06 |
| Last Update Date | 2016-06-06 |