Organization
PDG, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN GULON (PRSIDENT)
(651) 633-0500
Entity
Organization
Contact information
Practice address
605 HILLCREST AVE STE 210, OWATONNA, MN 55060-3680
(507) 451-5844
(507) 451-0756
Mailing address
2200 COUNTY ROAD C W STE 2210, ROSEVILLE, MN 55113-2551
(651) 746-2815
(651) 209-6312
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
02/15/2017
Last updated
10/28/2020
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