Organization
CARLYON DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANN M NORDIN (OFFICE MANAGER)
(906) 786-3891
Entity
Organization
Contact information
Practice address
1106 1ST AVE S, ESCANABA, MI 49829-3411
(906) 786-3891
(906) 786-3829
Mailing address
1106 1ST AVE S, ESCANABA, MI 49829-3411
(906) 786-3891
(906) 786-3829
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901012008
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1003279100
DENTIST
MI
01
—
1043310113
DENTIST
MI
Enumeration date
09/23/2016
Last updated
09/23/2016
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