Individual
DR. MYRON A HENRICKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
17436 KENWOOD TRL, LAKEVILLE, MN 55044
(952) 241-5899
(952) 241-5897
Mailing address
2200 COUNTY ROAD C W STE 2210, ROSEVILLE, MN 55113-2551
(952) 241-5899
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D9492
MN
Other
Enumeration date
04/11/2007
Last updated
07/26/2018
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