Organization
GROUP HEALTH PLAN, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID S GESKO DDS (SENIOR VP/DENTAL DIRECTION)
95288637577
Entity
Organization
Contact information
Practice address
8455 FLYING CLOUD DR, EDEN PRAIRIE, MN 55344-3974
(952) 883-9040
(952) 941-8857
Mailing address
8170 33RD AVE S, BLOOMINGTON, MN 55425-4516
(952) 883-5155
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
11643
MN
1223E0200X
Endodontics
11843
MN
1223P0221X
Pediatric Dentistry
12166
MN
1223P0300X
Periodontics
10651
MN
1223P0700X
Prosthodontics
12628
MN
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
12105
MN
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
12245
MN
125Q00000X
Oral Medicine Dentistry
13340
MN
Other
Enumeration date
05/11/2017
Last updated
05/11/2017
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