| Pdg, P.a. | |
|
12180 Business Park Boulevard North Champlin MN 55316-3123 | |
| (763) 421-5206 | |
| Not Available |
| Full Name | Pdg, P.a. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 12180 Business Park Boulevard North, Champlin, 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, P.a. 2100 County Road C W Suite 2210 Roseville MN 55113-2501 Ph: (651) 633-0500 | Pdg, P.a. 12180 Business Park Boulevard North Champlin MN 55316-3123 Ph: (763) 421-5206 |
| NPI Number | 1386710499 |
|---|---|
| Provider Enumeration Date | 11/28/2006 |
| Last Update Date | 10/28/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386710499 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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