Organization · Type 2 NPI

Pdg, PA

Dental Clinic/Center · Roseville, MN

NPI number 1104201284 Active

Practice location

1835 County Road C W, Suite 200
Roseville, MN 55113

Fax (651) 636-1118

Mailing address

2200 County Road C W, Suite 2210
Roseville, MN 55113-2550

Specialties and licenses

TaxonomyCodeLicense
Dental Clinic/Center Primary 261QD0000XNone listed

Dental Clinic/Center: Definition to come...

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About NPI 1104201284

Pdg, PA's National Provider Identifier is 1104201284, issued on Jul 30, 2015. The primary taxonomy on file is Dental Clinic/Center (261QD0000X), and the practice location is in Roseville, MN. The record was last updated on Oct 28, 2020.