Individual
MICHAEL L CARLSON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
W3275 WOLF RIVER ROAD, KESHENA, WI 54135
(715) 799-3361
(715) 799-3099
Mailing address
PO BOX 970, KESHENA, WI 54135-0970
(715) 799-3361
(715) 799-3099
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4900-015
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33749700
—
WI
Enumeration date
06/12/2006
Last updated
03/07/2023
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