Individual
DR. NICHOLAS MICHAEL CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
495 DUNLOP LN STE 112, CLARKSVILLE, TN 37040-5296
(931) 221-0050
Mailing address
495 DUNLOP LN STE 112, CLARKSVILLE, TN 37040-5296
(931) 221-0050
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
12442
TN
1223P0221X
Pediatric Dentistry
Primary
12442
TN
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
05/01/2022
Last updated
07/08/2024
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