Organization
METROPOLITAN PERIODONTISTS, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK M WILSON (OWNER)
(612) 332-0869
Entity
Organization
Contact information
Practice address
825 NICOLLET MALL, SUITE 210, MINNEAPOLIS, MN 55402-2606
(612) 332-0869
(612) 332-2891
Mailing address
825 NICOLLET MALL, SUITE 210, MINNEAPOLIS, MN 55402-2606
(612) 332-0869
(612) 332-2891
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
8580
MN
Other
Enumeration date
11/10/2006
Last updated
08/22/2020
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