Individual
RICHARD H CARLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
31 LONG WHARF MALL, NEWPORT, RI 02840-2906
(401) 846-9770
Mailing address
31 LONG WHARF MALL, NEWPORT, RI 02840-2906
(401) 846-9770
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
1475
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1475
LISCENCE NUMBER
RI
Enumeration date
12/27/2006
Last updated
07/08/2007
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