Provider Demographics
NPI:1811401375
Name:EDSTROM & HELGESON, P.A.
Entity Type:Organization
Organization Name:EDSTROM & HELGESON, P.A.
Other - Org Name:DENMARK DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:C
Authorized Official - Last Name:HELGESON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:651-452-4455
Mailing Address - Street 1:3436 DENMARK AVE
Mailing Address - Street 2:
Mailing Address - City:EAGAN
Mailing Address - State:MN
Mailing Address - Zip Code:55123-1088
Mailing Address - Country:US
Mailing Address - Phone:651-452-4455
Mailing Address - Fax:
Practice Address - Street 1:3436 DENMARK AVE
Practice Address - Street 2:
Practice Address - City:EAGAN
Practice Address - State:MN
Practice Address - Zip Code:55123-1088
Practice Address - Country:US
Practice Address - Phone:651-452-4455
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-20
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND12704261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental