Organization
ORTHODONTICS SPECIALIST OF MINNESOTA P.L.L.C.
Active
Organization
ORTHODONTICS SPECIALIST OF MINNESOTA P.L.L.C.
Active
Other names
The Dental Specialist-Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN GULON DDS (PRESIDENT)
(651) 746-2815
Entity
Organization
Contact information
Practice address
3360 NORTHDALE BLVD NW, COON RAPIDS, MN 55448
(651) 746-2815
(651) 209-6312
Mailing address
2200 COUNTY ROAD C W, #2210, ROSEVILLE, MN 55113-2550
(651) 633-0500
(651) 209-6312
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
04/12/2017
Last updated
10/28/2020
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