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8650 Hudson Blvd N Suite 105 Lake Elmo MN 55042 | |
| (651) 379-0564 | |
| (651) 501-1471 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 8650 Hudson Blvd N, Lake Elmo, Minnesota |
| Authorized Official Name and Position | John Gulon (PRESIDENT) |
| Authorized Official Contact | 6516330500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2200 County Road C W Suite 2210 Roseville MN 55113-2550 Ph: (651) 633-0500 | 8650 Hudson Blvd N Suite 105 Lake Elmo MN 55042 Ph: (651) 379-0564 |
| NPI Number | 1396120473 |
|---|---|
| Provider Enumeration Date | 07/30/2015 |
| Last Update Date | 10/28/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396120473 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
Group Health Plan, Inc. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 8515 Eagle Point Blvd, Lake Elmo, MN 55042 Phone: 651-523-9950 | |
Red Oak Family Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 9939 Hudson Blvd N # 107, Lake Elmo, MN 55042 Phone: 651-300-2334 | |
Valley Ridge Dental, Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 12425 55th St N, Lake Elmo, MN 55042 Phone: 651-439-0322 | |
Mcgann Family Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 8981 33rd St N, Lake Elmo, MN 55042 Phone: 651-777-1337 |