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
DR. JOHN GULON DDS (PRESIDENT)
(651) 746-2815
Entity
Organization
Contact information
Practice address
1109 MOORE LAKE DR E, FRIDLEY, MN 55432
(763) 572-2224
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
06/04/2018
Last updated
10/28/2020
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