MEDICARE: DR. TODD H HULSE DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	D10200	MN

General Provider Information

NPI Number	:	1881642338
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TODD H HULSE DDS

Provider Business Mailing Address
First Line	:	4001 STINSON BLVD NE
Second Line	:	SUITE 320
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55421-3424
Country	:	US
Telephone Number	:	612-788-3666
Fax Number	:	612-782-9260

Provider Business Practice Location Address
First Line	:	4001 STINSON BLVD NE
Second Line	:	SUITE 320
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55421-3424
Country	:	US
Telephone Number	:	612-788-3666
Fax Number	:	612-782-9260

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/05/2006
Last Update Date	:	07/08/2007

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