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1835 Cty Rd C-west Suite 220 Roseville MN 55113-1343 | |
| (651) 636-2123 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1835 Cty Rd C-west, Roseville, 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 55113-2504 Ph: (651) 746-2804 | 1835 Cty Rd C-west Suite 220 Roseville MN 55113-1343 Ph: (651) 636-2123 |
| NPI Number | 1104985456 |
|---|---|
| Provider Enumeration Date | 12/06/2006 |
| Last Update Date | 10/28/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104985456 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
Northland Dental Partners, Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2690 Snelling Ave N Ste 200, Roseville, MN 55113 Phone: 651-633-1834 Fax: 651-633-0995 | |
Michael J. Petersen, D.d.s., P.a. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3101 Old Highway 8 Ste 303, Roseville, MN 55113 Phone: 651-636-0840 | |
Prosthodontic Associates, Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2233 Hamline Ave N, Suite 210, Roseville, MN 55113 Phone: 651-633-4914 Fax: 651-633-5126 |