Individual
DR. MICHAEL HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3200 LEXINGTON AVE N STE B, SHOREVIEW, MN 55126-8118
(651) 255-8888
Mailing address
3200 LEXINGTON AVE N STE B, SHOREVIEW, MN 55126-8118
(651) 255-8888
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D13957
MN
1223G0001X
General Practice Dentistry
D13957
MN
Other
Enumeration date
03/05/2017
Last updated
02/16/2021
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