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General NPI Number Information
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NPI Number | 1487602439
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Entity Type | Individual
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Provider Name | GARY JAMES HEDIN DDS
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Gender | Male
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Dates
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Enumeration Date | 05/04/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 324 W. SUPERIOR ST, #1111 DOWNTOWN DENTAL CARE OF DULUTH
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City | DULUTH
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State | MN
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Zip | 55802
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Country | US
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Telephone | 218-722-3679
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Fax |
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Provider Business Mailing Address
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Address Line | 102 S 30TH AVE E
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City | DULUTH
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State | MN
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Zip | 55812-2359
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Country | US
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Telephone | 218-464-2146
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | D11959
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License Number State | MN
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