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Organization
PDG, P.A
Active
Organization
PDG, P.A
Active
Other names
Park Dental Cedar Valley
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNON HESSE (CREDENTIALING SPECIALIST)
(651) 746-2815
Entity
Organization
Contact information
Practice address
14135 CEDAR AVE STE 500, APPLE VALLEY, MN 55124-4527
(952) 891-4611
(952) 891-4370
Mailing address
2200 COUNTY ROAD C W STE 2210, ROSEVILLE, MN 55113-2551
(651) 746-2815
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
10/02/2019
Last updated
10/28/2020
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