Organization
KERRY CARLSON DDS,PLLC
Active
Other names
Kerry Carlson DDS,PLLC, Blue Skye Dental
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER D IHLE (BUSINESS ADMINISTRATOR)
(479) 754-2042
Entity
Organization
Contact information
Practice address
1619 W MAIN ST STE A, CLARKSVILLE, AR 72830-3225
(479) 754-2042
(479) 754-2429
Mailing address
1619 W MAIN ST STE A, CLARKSVILLE, AR 72830-3225
(479) 754-2042
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
10/28/2020
Last updated
10/28/2020
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