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Organization

ADVANCED DENTAL GROUP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RAYMOND A HELLICKSON D.D.S. (DENTIST/OWNER)
(612) 789-3573
Entity
Organization

Contact information

Practice address
3909 SILVER LAKE RD NE, MINNEAPOLIS, MN 55421-4352
(612) 789-3573
Mailing address
3909 SILVER LAKE RD NE, MINNEAPOLIS, MN 55421-4352
(612) 789-3573

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
D11408
MN
1223G0001X
General Practice Dentistry
Primary
D6670
MN
1223G0001X
General Practice Dentistry
D7712
MN
1223G0001X
General Practice Dentistry
D7910
MN
1223P0300X
Periodontics
D10650
MN

Other

Enumeration date
04/17/2008
Last updated
04/17/2008
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