Organization
GRAND MARAIS FAMILY DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALYSSA HEDSTROM (PRESIDENT)
(218) 387-2774
Entity
Organization
Contact information
Practice address
303 E 3RD ST, GRAND MARAIS, MN 55604
(218) 387-2774
(218) 387-1393
Mailing address
PO BOX 670, GRAND MARAIS, MN 55604-0670
(218) 387-2774
(218) 387-1393
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D11942
MN
Other
Enumeration date
09/03/2013
Last updated
09/03/2013
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