OrganizationMichael Henrickson Dds(Henrickson Dental)Clinic/CenterAmbulatory Health Care FacilitiesPractice Address1560 Beam Ave Ste A, Maplewood, MN 55109-1171(651) 777-8900PECOS EnrollmentBased on the most recent information from CMS, provider Michael Henrickson Dds does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 10:37 AM.Profile DetailsProvider ID1861054090Provider TypeOrganizationFull NameMichael Henrickson DdsOther NameHenrickson DentalSubpartNoEnumeration Date7/9/2019Last Updated11/28/2023Contact InformationPractice LocationPractice Address1560 Beam Ave Ste A, Maplewood, MN 55109-1171Phone(651) 777-8900Fax(651) 777-8908Mailing LocationMailing Address1560 Beam Ave Ste A, Maplewood, MN 55109-1171Phone(651) 777-8900Fax(651) 777-8908Authorized OfficialNameHenrickson, Mike Ryan (Authorized Official)Phone(651) 777-8900Provider TaxonomiesCodeDescriptionLicenseCode261QD0000XPrimaryDescriptionClinic/CenterAmbulatory Health Care FacilitiesLicenseUnlisted Issuer