| Paul J Henningson Dds Pa | |
|
501 Maple Street Brainerd MN 56401-3527 | |
| (218) 829-9403 | |
| Not Available |
| Full Name | Paul J Henningson Dds Pa |
|---|---|
| Speciality | Dentist |
| Location | 501 Maple Street, Brainerd, Minnesota |
| Authorized Official Name and Position | Paul John Henningson (PRESIDENT) |
| Authorized Official Contact | 2188299403 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Paul J Henningson Dds Pa 501 Maple Street Brainerd MN 56401-3527 Ph: (218) 829-9403 | Paul J Henningson Dds Pa 501 Maple Street Brainerd MN 56401-3527 Ph: (218) 829-9403 |
| NPI Number | 1285602664 |
|---|---|
| Provider Enumeration Date | 03/10/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285602664 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | D11047 (Minnesota) | Primary |
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