Organization · Type 2 NPI

Family Periodontic Specialists, PLC

Periodontics · Maple Grove, MN

NPI number 1487303889 Active

Practice location

15785 95th Ave N
Maple Grove, MN 55369-4404

Fax (763) 420-3158

Specialties and licenses

Taxonomy	Code	License
Periodontics Primary	1223P0300X	None listed

Periodontics: That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.

14 other providers at this address

Other periodontics providers in Maple Grove

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NPI record

NPI: 1487303889
Entity type: Organization (Type 2)
Issued: Mar 22, 2022
Last updated: Mar 22, 2022
Status: Active
Subpart: Yes of Family Periodontic Specialists, PLC

Other names

Metro Dentalcare Specialty Center Maple Grove - Periodontics · doing business as

Authorized official

Celia Hayes
Credentialing Coordinator
(217) 540-2100

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1487303889

Family Periodontic Specialists, PLC's National Provider Identifier is 1487303889, issued on Mar 22, 2022. The primary taxonomy on file is Periodontics (1223P0300X), and the practice location is in Maple Grove, MN. The record was last updated on Mar 22, 2022.