Organization
PDG,P.A.
Active
Other names
Park Dental Edinborough way
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNON HESSE (CREDENTIALING SPECIALIST)
(651) 746-2815
Entity
Organization
Contact information
Practice address
3300 EDINBOROUGH WAY STE 210, EDINA, MN 55435-5958
(952) 831-1112
Mailing address
2200 COUNTY ROAD C W STE 2210, ROSEVILLE, MN 55113-2551
(651) 633-0500
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
12/30/2020
Last updated
12/30/2020
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