Park Dental | |
917 Grand Ave Saint Paul MN 55105-3043 | |
(651) 221-1902 | |
Not Available |
Full Name | Park Dental |
---|---|
Speciality | Dentist - General Practice |
Location | 917 Grand Ave, Saint Paul, 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 |
---|---|
Park Dental 2200 County Road C W Suite 2210 Roseville MN 55113-2504 Ph: (651) 746-2804 | Park Dental 917 Grand Ave Saint Paul MN 55105-3043 Ph: (651) 221-1902 |
NPI Number | 1417015009 |
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Provider Enumeration Date | 12/05/2006 |
Last Update Date | 10/28/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1417015009 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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