Organization
PERIODONTAL CARE, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDGAR DAVID RAJEK JR. DDS (PRESIDENT)
(952) 432-0010
Entity
Organization
Contact information
Practice address
7493 147TH ST W, SUITE 105, APPLE VALLEY, MN 55124-4505
(952) 432-0010
(952) 432-0011
Mailing address
7493 147TH ST W, SUITE 105, APPLE VALLEY, MN 55124-4505
(952) 432-0010
(952) 432-0011
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
8037
MN
Other
Enumeration date
04/26/2007
Last updated
08/22/2020
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