Individual
DR. BRUCE R CARLYON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1106 1ST AVE S, ESCANABA, MI 49829-3411
(906) 786-3891
(906) 786-3829
Mailing address
1106 1ST AVE S, ESCANABA, MI 49829-3411
(906) 786-3891
(906) 786-3829
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12008
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4047589
—
MI
Enumeration date
09/25/2006
Last updated
07/08/2007
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