Organization
MICHAEL HENRICKSON DDS
Active
Other names
henrickson dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MIKE RYAN HENRICKSON DDS (AUTHORIZED OFFICIAL)
(651) 777-8900
Entity
Organization
Contact information
Practice address
1560 BEAM AVE STE A, MAPLEWOOD, MN 55109-1171
(651) 777-8900
(651) 777-8908
Mailing address
1560 BEAM AVE STE A, MAPLEWOOD, MN 55109-1171
(651) 777-8900
(651) 777-8908
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
07/09/2019
Last updated
11/28/2023
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