| Metropolitan Periodontists, P.a. | |
|
825 Nicollet Mall Suite 210 Minneapolis MN 55402-2606 | |
| (612) 332-0869 | |
| (612) 332-2891 |
| Full Name | Metropolitan Periodontists, P.a. |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 825 Nicollet Mall, Minneapolis, Minnesota |
| Authorized Official Name and Position | Mark M Wilson (OWNER) |
| Authorized Official Contact | 6123320869 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Metropolitan Periodontists, P.a. 825 Nicollet Mall Suite 210 Minneapolis MN 55402-2606 Ph: (612) 332-0869 | Metropolitan Periodontists, P.a. 825 Nicollet Mall Suite 210 Minneapolis MN 55402-2606 Ph: (612) 332-0869 |
| NPI Number | 1982775235 |
|---|---|
| Provider Enumeration Date | 11/10/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982775235 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | 8580 (Minnesota) | Primary |
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