| NPI | 1861054090 |
|---|---|
| Doing Business As | HENRICKSON DENTAL |
| Entity Type | Organization |
| Authorized Contact | MIKE RYAN HENRICKSON Authorized Official 651-777-8900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2019-07-09 |
| Last Update Date | 2023-11-28 |