Individual
KURT W. CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
800 LASALLE AVE, MINNEAPOLIS, MN 55402
(612) 338-4546
Mailing address
800 LASALLE AVE, MINNEAPOLIS, MN 55402-2006
(612) 338-4546
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D8994
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1255369278
CORPORATION NPI
MN
Enumeration date
10/19/2006
Last updated
07/10/2018
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