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3360 Northdale Blvd Nw Coon Rapids MN 55448 | |
| (651) 746-2815 | |
| (651) 209-6312 |
| Full Name | |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 3360 Northdale Blvd Nw, Coon Rapids, Minnesota |
| Authorized Official Name and Position | John Gulon (PRESIDENT) |
| Authorized Official Contact | 6517462815 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2200 County Road C W #2210 Roseville MN 55113-2550 Ph: (651) 633-0500 | 3360 Northdale Blvd Nw Coon Rapids MN 55448 Ph: (651) 746-2815 |
| NPI Number | 1700310299 |
|---|---|
| Provider Enumeration Date | 04/12/2017 |
| Last Update Date | 10/28/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700310299 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | (* (Not Available)) | Primary |
Riverdale Pediatric Dentistry P.a. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3585 124th Ave Nw, Ste 400, Coon Rapids, MN 55433 Phone: 763-767-1524 Fax: 763-767-1528 | |
Minnesota Dental Professionals, P.c. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 11237 Foley Blvd Nw, Coon Rapids, MN 55448 Phone: 763-757-1234 | |
Osage Dental Associates Pa Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 11441 Osage St Nw, Coon Rapids, MN 55433 Phone: 763-757-6600 Fax: 763-757-3693 |