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Individual

DR. GLENN ALLEN HULTSTRAND

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
8120 PENN AVE SO, STE 115, BLOOMINGTON, MN 55431-1326
(952) 746-8188
(952) 746-4865
Mailing address
8120 PENN AVE SO, STE 115, BLOOMINGTON, MN 55431-1326
(952) 746-8188

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
9349
MN

Other

Enumeration date
12/20/2006
Last updated
05/20/2009
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