| Parkway Dental | |
|
4730 Chicago Ave Minneapolis MN 55407-3570 | |
| (612) 824-4211 | |
| (612) 824-2904 |
| Full Name | Parkway Dental |
|---|---|
| Speciality | Dentist |
| Location | 4730 Chicago Ave, Minneapolis, Minnesota |
| Authorized Official Name and Position | Catalin Constantin (PRESIDENT/OWNER) |
| Authorized Official Contact | 6465156607 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Parkway Dental 4730 Chicago Ave Minneapolis MN 55407-3570 Ph: (612) 824-4211 | Parkway Dental 4730 Chicago Ave Minneapolis MN 55407-3570 Ph: (612) 824-4211 |
| NPI Number | 1255508966 |
|---|---|
| Provider Enumeration Date | 05/12/2008 |
| Last Update Date | 07/31/2020 |
| Medicare PECOS PAC ID | 9830514397 |
|---|---|
| Medicare Enrollment ID | O20200731001222 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255508966 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | D11856 (Minnesota) | Primary |
| Provider Name | Raymond A Hellickson |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1245303775 PECOS PAC ID: 4688856156 Enrollment ID: I20110305000042 |
| Provider Name | Catalin Constantin |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1710976865 PECOS PAC ID: 4486955093 Enrollment ID: I20200904001175 |
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