Organization
PDG, PA
Active
Parent organization
PDG, P.A.
Other names
Facial Pain Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
PDG, P.A.
Authorized official
DR. JOHN GULON DDS (PRESIDENT)
(651) 633-0500
Entity
Organization
Contact information
Practice address
8650 HUDSON BLVD N, SUITE 105, LAKE ELMO, MN 55042
(651) 379-0564
(651) 501-1471
Mailing address
2200 COUNTY ROAD C W, SUITE 2210, ROSEVILLE, MN 55113-2550
(651) 633-0500
(651) 636-6350
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
07/30/2015
Last updated
10/28/2020
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