Organization
PDG, P.A.
Active
Parent organization
PDG, P.A.
Other names
Park Dental
Organization subpart
Yes
Provider details
NPI number
Legal business name
PDG, P.A.
Authorized official
DR. JOHN GULON D.D.S. (PRESIDENT)
(651) 633-0500
Entity
Organization
Contact information
Practice address
12180 BUSINESS PARK BOULEVARD NORTH, CHAMPLIN, MN 55316-3123
(763) 421-5206
Mailing address
2100 COUNTY ROAD C W, SUITE 2210, ROSEVILLE, MN 55113-2501
(651) 633-0500
(651) 636-6350
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
11/28/2006
Last updated
10/28/2020
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