Organization
OP ORTHODONTICS OF MINNESOTA PLLC
Active
Other names
Carlson Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
CHAD HENDRICKS (CREDENTIALING)
(612) 859-0444
Entity
Organization
Contact information
Practice address
3701 TOWER AVE, SUPERIOR, WI 54880-5338
(218) 460-5417
Mailing address
3701 TOWER AVE, SUPERIOR, WI 54880-5338
(218) 460-5417
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
12/07/2021
Last updated
12/07/2021
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