Individual
STEPHEN GLENN DAHLGREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
5086 MILLER TRUNK HWY, HERMANTOWN, MN 55811-1490
(218) 729-9810
(218) 729-9812
Mailing address
5086 MILLER TRUNK HWY, HERMANTOWN, MN 55811-1490
(218) 729-9810
(218) 729-9812
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
8279
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
74450DA
BLUECROSS BLUESHIELD
MN
Enumeration date
12/18/2006
Last updated
07/08/2007
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