PDG PA NPI 1629589544

NPI Information

NPI: 1629589544
Provider Name: PDG, PA

Doing Business As: PARK DENTAL

Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

Address:
16991 198TH AVE NW
BIG LAKE, MN
ZIP 55309
Phone: (763) 263-6350
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PDG, PA is a dental clinic center in Big Lake, MN. PDG, PA NPI is 1629589544. The provider is registered as an organization entity type.
The provider Is Doing Business As Park Dental.

The provider's business location address is:

16991 198TH AVE NW
BIG LAKE, MN
ZIP 55309
Phone: (763) 263-6350
Fax: (763) 263-0136

The provider's authorized official is Shannon Hesse .
The authorized official title is Credentialing Specialist and has the following contact phone number (651) 746-2815.

The enumeration date for this NPI number is 10/18/2017 and was last updated on 10/28/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QD0000X	Clinic/Center	Dental			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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