Organization
MICHAEL R HENRICKSON DDS, PLLC
Active
Other names
Twin Cities Modern Dentistry-Burnsville
Organization subpart
No
Provider details
NPI number
Authorized official
CRYSTAL MILLER OM (MANAGER)
(651) 777-8900
Entity
Organization
Contact information
Practice address
14050 NICOLLET AVE, 205, BURNSVILLE, MN 55337
(952) 435-4177
Mailing address
14050 NICOLLET AVE, 205, BURNSVILLE, MN 55337
(952) 435-4177
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
MN
Other
Enumeration date
08/22/2017
Last updated
08/22/2017
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