Individual
MS. JULIE ANN CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
3600 TOWER AVE, SUITE 2, SUPERIOR, WI 54880-5337
(715) 394-5411
Mailing address
3600 TOWER AVE, SUITE 2, SUPERIOR, WI 54880-5337
(715) 394-5411
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
4819
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4819
STATE LICENSE
WI
Enumeration date
03/06/2007
Last updated
07/08/2007
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