Pdg, PA

NPI #1629589544 in Big Lake, Minnesota

Provider Information

NPI Number
1629589544
Entity Type
Organization
Organization Name
Pdg, PA
Primary Specialty
Clinic/Center - Dental
Enumeration Date
Oct 18, 2017
Last Updated
Oct 28, 2020

Practice Location

Address
16991 198TH AVE NW
ZIP Code
55309
Phone
(763) 263-6350

Authorized Official

Name
SHANNON HESSE
Title
CREDENTIALING SPECIALIST
Phone
(651) 746-2815

Specialties & Taxonomy Codes

Specialty
Clinic/Center - DentalDental

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