| Pdg, P.a | |
|
14135 Cedar Ave Ste 500 Apple Valley MN 55124-4527 | |
| (952) 891-4611 | |
| (952) 891-4370 |
| Full Name | Pdg, P.a |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 14135 Cedar Ave Ste 500, Apple Valley, 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 Ste 2210 Roseville MN 55113-2551 Ph: (651) 746-2815 | Pdg, P.a 14135 Cedar Ave Ste 500 Apple Valley MN 55124-4527 Ph: (952) 891-4611 |
| NPI Number | 1841831799 |
|---|---|
| Provider Enumeration Date | 10/02/2019 |
| Last Update Date | 10/28/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841831799 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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