Individual
DR. RICHARD G. CARLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
313 NW 3RD ST, BRAINERD, MN 56401-3226
(218) 829-9563
Mailing address
313 NW 3RD ST, BRAINERD, MN 56401-3226
(218) 829-9563
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8697
MN
Other
Enumeration date
10/19/2006
Last updated
07/08/2007
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