| Pdg, P.a. | |
|
15015 Cimarron Ave Rosemount MN 55068-2771 | |
| (952) 423-2288 | |
| (952) 423-2203 |
| Full Name | Pdg, P.a. |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 15015 Cimarron Ave, Rosemount, 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, P.a. 2200 County Road C W Suite 2210 Roseville MN 55113-2550 Ph: (651) 633-0500 | Pdg, P.a. 15015 Cimarron Ave Rosemount MN 55068-2771 Ph: (952) 423-2288 |
| NPI Number | 1538598057 |
|---|---|
| Provider Enumeration Date | 11/05/2013 |
| Last Update Date | 01/27/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538598057 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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