Organization
PAUL J HENNINGSON DDS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL JOHN HENNINGSON DDS (PRESIDENT)
(218) 829-9403
Entity
Organization
Contact information
Practice address
501 MAPLE STREET, BRAINERD, MN 56401-3527
(218) 829-9403
Mailing address
501 MAPLE STREET, BRAINERD, MN 56401-3527
(218) 829-9403
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D11047
MN
Other
Enumeration date
03/10/2006
Last updated
08/22/2020
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