Provider Demographics
NPI:1508931965
Name:HEDGLIN, ERNEST ALLEN (DDS)
Entity Type:Individual
Prefix:
First Name:ERNEST
Middle Name:ALLEN
Last Name:HEDGLIN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 WEST MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:MELROSE
Mailing Address - State:MN
Mailing Address - Zip Code:56352
Mailing Address - Country:US
Mailing Address - Phone:320-256-4267
Mailing Address - Fax:320-256-4167
Practice Address - Street 1:615 WEST MAIN STREET
Practice Address - Street 2:
Practice Address - City:MELROSE
Practice Address - State:MN
Practice Address - Zip Code:56352
Practice Address - Country:US
Practice Address - Phone:320-256-4267
Practice Address - Fax:320-256-4167
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN8496122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist