Individual
NOLAN RYAN CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
280 60TH ST SE, SUITE #200, GRAND RAPIDS, MI 49548
(616) 483-0750
Mailing address
280 60TH ST SE, SUITE #200, GRAND RAPIDS, MI 49548
(616) 483-0750
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
2902018221
MI
Other
Enumeration date
10/03/2024
Last updated
10/03/2024
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