Carlson Dental Group Providers, LLC
NPI #1265867691 in Jacksonville, Florida
Provider Information
- NPI Number
- 1265867691
- Entity Type
- Organization
- Organization Name
- Carlson Dental Group Providers, LLC
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Sep 4, 2013
- Last Updated
- Sep 4, 2013
Practice Location
- Address
- 13241 BARTRAM PARK BLVD
- Address 2
- BLDG 1700
- City
- Jacksonville
- State
- Florida
- ZIP Code
- 32258-5212
- Phone
- (904) 262-8409
Authorized Official
- Name
- DR. RICHARD DEAN CARLSON, DMD
- Title
- OWNER
- Phone
- (904) 262-8409
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
| Dentist - Oral and Maxillofacial Surgery — Oral and Maxillofacial Surgery |
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