Orthodontic Specialists of Minnesota, P.l.l.c.

NPI #1306338553 in Fridley, Minnesota

Provider Information

NPI Number: 1306338553
Entity Type: Organization
Organization Name: Orthodontic Specialists of Minnesota, P.l.l.c.
Primary Specialty: Dentist - Orthodontics and Dentofacial Orthopedics
Enumeration Date: Jun 4, 2018
Last Updated: Oct 28, 2020

Practice Location

Address: 1109 MOORE LAKE DR E
City: Fridley
State: Minnesota
ZIP Code: 55432
Phone: (763) 572-2224

Authorized Official

Name: DR. JOHN GULON, DDS
Title: PRESIDENT
Phone: (651) 746-2815

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - Orthodontics and Dentofacial Orthopedics — Orthodontics and Dentofacial Orthopedics	1223X0400X	Primary

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