Pdg,p.A.
Dentist, General Practice in Edina, MN. Organization (NPI-2).
NPI number1083772669
StatusActive
Last updated in NPPESOct 28, 2020
Details
- NPI
- 1083772669
- Entity type
- Organization (NPI-2)
- Legal business name
- Pdg,p.A.
- Organization subpart
- Yes
- Enumeration date
- Dec 5, 2006
- Certification date
- Oct 28, 2020
- Last updated
- Oct 28, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | – | – | Yes |
Other names
- Park Dental (Doing Business As)
Practice location
6545 France Ave SSuite 390
Edina, MN 55435-2131
Phone 952-926-3534
Mailing address
2200 County Road C WSuite 2210
Roseville, MN 55113-2504
Phone 651-633-0500 · Fax 651-636-6350
Authorized official
John Gulon
President
6516330500
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