Individual
JACK KYLE CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3115 UNIVERSITY DR S, FARGO, ND 58103-6049
(701) 232-8884
(701) 232-8884
Mailing address
3115 UNIVERSITY DR S, FARGO, ND 58103-6049
(701) 232-8884
(701) 232-8884
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2588
ND
Other
Enumeration date
06/10/2026
Last updated
06/10/2026
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