Individual
DR. ERIC TODD CARLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
12725 43RD ST NE STE 202, SAINT MICHAEL, MN 55376-4929
(763) 497-2367
(763) 497-8171
Mailing address
12725 43RD ST NE STE 202, SAINT MICHAEL, MN 55376-4929
(763) 497-2367
(763) 497-8171
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D12093
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
58492400
—
MN
Enumeration date
12/06/2006
Last updated
01/06/2012
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