| Gary L. Carlson, D.d.s., P.a. | |
|
17809 Hutchins Dr Ste 101 Minnetonka MN 55345-4100 | |
| (952) 474-3203 | |
| (952) 474-3204 |
| Full Name | Gary L. Carlson, D.d.s., P.a. |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 17809 Hutchins Dr, Minnetonka, Minnesota |
| Authorized Official Name and Position | Gary Leroy Carlson (PRESIDENT) |
| Authorized Official Contact | 9524743203 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gary L. Carlson, D.d.s., P.a. 17809 Hutchins Dr Ste 101 Minnetonka MN 55345-4100 Ph: (952) 474-3203 | Gary L. Carlson, D.d.s., P.a. 17809 Hutchins Dr Ste 101 Minnetonka MN 55345-4100 Ph: (952) 474-3203 |
| NPI Number | 1538225677 |
|---|---|
| Provider Enumeration Date | 12/30/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538225677 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | D6852 (Minnesota) | Primary |
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