Individual
DR. TRICIA CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
26357 FOREST BLVD, STE 2, WYOMING, MN 55092-8353
(651) 462-7017
Mailing address
PO BOX 845, WYOMING, MN 55092-0845
(651) 462-7017
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D11193
MN
Other
Enumeration date
03/21/2007
Last updated
07/08/2007
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