Organization
BRUCE R CARLYON DDS
Active
Other names
Carlyon Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRUCE R CARLYON DDS (OWNER)
(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
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1003279100
—
MI
05
—
1043310113
—
MI
Enumeration date
07/30/2020
Last updated
07/30/2020
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