Organization
GARY L. CARLSON, D.D.S., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY LEROY CARLSON D.D.S., M.S.D. (PRESIDENT)
(952) 474-3203
Entity
Organization
Contact information
Practice address
17809 HUTCHINS DR, STE 101, MINNETONKA, MN 55345-4100
(952) 474-3203
(952) 474-3204
Mailing address
17809 HUTCHINS DR, STE 101, MINNETONKA, MN 55345-4100
(952) 474-3203
(952) 474-3204
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
D6852
MN
Other
Enumeration date
12/30/2006
Last updated
08/22/2020
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