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Organization

PDG, PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JOHN GULON (PRESIDENT)
(651) 633-0500
Entity
Organization

Contact information

Practice address
901 MARQUETTE AVE STE 230, MINNEAPOLIS, MN 55402-3260
(612) 333-1066
(612) 333-0108
Mailing address
2200 COUNTY ROAD C W, #2210, ROSEVILLE, MN 55113-2550
(651) 746-2815
(651) 209-6312

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary

Other

Enumeration date
09/15/2016
Last updated
04/22/2020
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