Hendrickson, Matthew
Hendrickson, Matthew is an individual health care provider with primary practice located at 8980 Hudson Blvd N , Lake Elmo MN 55042-9704. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Hendrickson, Matthew can be contacted via phone (651) 735-9057.Contact Information
Primary practice address
8980 Hudson Blvd N
Lake Elmo MN 55042-9704
Phone: (651) 735-9057
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | D12263 | Minnesota |
Profile Details
| NPI number | 1861554719 |
|---|---|
| LBN Legal business name | Hendrickson, Matthew |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 15th, 2006 |
| Last updated | Jul 21st, 2022 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1861554719 | NPPES |
| Minnesota | MEDICAID | 137739600 |
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