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PDG P.A. NPI 1760540165


NPI Information

NPI: 1760540165
Provider Name: PDG, P.A.

Doing Business As: PARK DENTAL

Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

CLIA Number: 24D2243826

Address:
5000 W 36TH ST
SUITE 250
ST LOUIS PARK, MN
ZIP 55416
Phone: (952) 920-3700
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PDG, P.A. is a general practice dentist in St Louis Park, MN. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. PDG, P.A. NPI is 1760540165. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Park Dental.

The provider's business location address is:

5000 W 36TH ST
SUITE 250
ST LOUIS PARK, MN
ZIP 55416-758
Phone: (952) 920-3700
Fax: (952) 926-1601

The provider's authorized official is John Gulon .
The authorized official title is President and has the following contact phone number (651) 633-0500.

The CLIA number assigned to this NPI record is 24D2243826 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/5/2006 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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223G0001XDentistGeneral PracticeYes

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: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.