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
3780 MARKETPLACE DR NW STE 112, ROCHESTER, MN 55901-3225
(507) 288-1633
(507) 288-2716
Mailing address
2200 COUNTY ROAD C W, STE 2210, ROSEVILLE, MN 55113-2550
(651) 636-6350
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
04/21/2016
Last updated
07/21/2022
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