Organization
ORTHODONTIC SPECIALISTS OF MINNESOTA, P.L.L.C.
Active
Other names
The Dental Specialists- Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN GULON DDS (PRESIDENT)
(651) 746-2815
Entity
Organization
Contact information
Practice address
8650 HUDSON BLVD N STE 105, LAKE ELMO, MN 55042
(651) 268-2992
Mailing address
2200 COUNTY ROAD C W STE 2210, ROSEVILLE, MN 55113-2551
(651) 746-2815
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
06/05/2018
Last updated
10/28/2020
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