| Pdg, Pa | |
| 
					16991 198th Ave Nw Big Lake MN 55309  | |
| (763) 263-6350 | |
| (763) 263-0136 | 
| Full Name | Pdg, Pa | 
|---|---|
| Speciality | Clinic/center - Dental | 
| Location | 16991 198th Ave Nw, Big Lake, Minnesota | 
| Authorized Official Name and Position | Shannon Hesse (CREDENTIALING SPECIALIST) | 
| Authorized Official Contact | 6517462815 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Pdg, Pa 2200 County Road C W Ste 2210 Roseville MN 55113-2551 Ph: (651) 746-2815  | Pdg, Pa 16991 198th Ave Nw Big Lake MN 55309 Ph: (763) 263-6350  | 
| NPI Number | 1629589544 | 
|---|---|
| Provider Enumeration Date | 10/18/2017 | 
| Last Update Date | 10/28/2020 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1629589544 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary | 
Dental Services Inc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 195 Jefferson Blvd, Big Lake, MN 55309 Phone: 763-263-2222 Fax: 763-263-5822  | |
Ks Holdings Pa Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 751 Rose Dr Nw, Suite 108, Big Lake, MN 55309 Phone: 763-262-0259  | |
Modern Dental Professionals Mn Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 195 Jefferson Blvd, Big Lake, MN 55309 Phone: 763-280-5711 Fax: 763-263-5822  | |
Central Minnesota Pediatric Dentists Pa Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 570 Humboldt Dr Ste 102, Big Lake, MN 55309 Phone: 320-253-0272 Fax: 320-251-2661  | |
Corner Oaks Family Dental Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 290 Eagle Lake Rd N, Big Lake, MN 55309 Phone: 763-263-3262  | |
Reed D. Dill, D.d.s. P.a. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 171 Lake St N, Big Lake, MN 55309 Phone: 763-263-3262 Fax: 763-263-7998  | |
Big Lake Dental, Pa Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 16991 198th Avenue Nw, Big Lake, MN 55309 Phone: 763-263-6350 Fax: 763-263-0136  |