| Alyssa A Hedstrom, D.d.s. | |
|
303 E. 3rd St. Grand Marais MN 55604-0670 | |
| (218) 387-2774 | |
| (218) 387-1393 |
| Full Name | Alyssa A Hedstrom, D.d.s. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 303 E. 3rd St., Grand Marais, Minnesota |
| Authorized Official Name and Position | Alyssa A Hedstrom (OWNER) |
| Authorized Official Contact | 2183872774 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Alyssa A Hedstrom, D.d.s. 303 E. 3rd St. P.o. Box 670 Grand Marais MN 55604-0670 Ph: (218) 387-2774 | Alyssa A Hedstrom, D.d.s. 303 E. 3rd St. Grand Marais MN 55604-0670 Ph: (218) 387-2774 |
| NPI Number | 1326242678 |
|---|---|
| Provider Enumeration Date | 06/12/2007 |
| Last Update Date | 05/01/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326242678 | NPI | - | NPPES |
| 580060000 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | D11942 (Minnesota) | Primary |
Grand Marais Family Dentistry Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 303 E 3rd St, Grand Marais, MN 55604 Phone: 218-387-2774 Fax: 218-387-1393 |