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Contact Information

MYRON A HENRICKSON, DDS
17436 KENWOOD TRL
LAKEVILLE, MN55044
 Phone: 952-241-5899
 Fax: 952-241-5897
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for MYRON A HENRICKSON · (Male)

NPI # 1023231776
Status Active
Credentials DDS (Doctor of Dental Surgery)
Entity Individual
Enumeration date 04/11/2007
Last updated 07/26/2018 - About 8 years ago
Sole proprietor 1 Yes
Identifiers
  • MN License # D9492
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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