| Pdg, Pa | |
|
8650 Hudson Blvd N Suite 105 Lake Elmo MN 55042 | |
| (651) 379-0564 | |
| (651) 501-1471 |
| Full Name | Pdg, Pa |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 8650 Hudson Blvd N, Lake Elmo, Minnesota |
| Authorized Official Name and Position | John Gulon (PRESIDENT) |
| Authorized Official Contact | 6516330500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pdg, Pa 2200 County Road C W Suite 2210 Roseville MN 55113-2550 Ph: (651) 633-0500 | Pdg, Pa 8650 Hudson Blvd N Suite 105 Lake Elmo MN 55042 Ph: (651) 379-0564 |
| NPI Number | 1396120473 |
|---|---|
| Provider Enumeration Date | 07/30/2015 |
| Last Update Date | 10/28/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396120473 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
Group Health Plan, Inc. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 8515 Eagle Point Blvd, Lake Elmo, MN 55042 Phone: 651-523-9950 | |
Red Oak Family Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 9939 Hudson Blvd N # 107, Lake Elmo, MN 55042 Phone: 651-300-2334 | |
Valley Ridge Dental, Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 12425 55th St N, Lake Elmo, MN 55042 Phone: 651-439-0322 | |
Mahtomedi Dental P.c. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 12425 55th St N, Lake Elmo, MN 55042 Phone: 651-430-1020 Fax: 651-439-2201 | |
Orthodontic Specialists Of Minnesota, P.l.l.c. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 8650 Hudson Blvd N Ste 105, Lake Elmo, MN 55042 Phone: 651-268-2992 | |
St Croix Valley Dental Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 10035 City Walk Dr, Ste A Lake Elmo Dental, Lake Elmo, MN 55042 Phone: 651-714-5555 Fax: 651-439-2211 | |
Mcgann Family Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 8981 33rd St N, Lake Elmo, MN 55042 Phone: 651-777-1337 |