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

NPI #1902398944 in Blaine, Minnesota

Provider Information

NPI Number: 1902398944
Entity Type: Organization
Organization Name: Orthodontic Specialists of Minnesota, P.l.l.c.
Primary Specialty: Dentist - Orthodontics and Dentofacial Orthopedics
Enumeration Date: Jun 5, 2018
Last Updated: Oct 28, 2020

Practice Location

Address: 12904 CENTRAL AVE NE
City: Blaine
State: Minnesota
ZIP Code: 55434
Phone: (763) 201-6960

Authorized Official

Name: JOHN GULON, DDS
Title: PRESEIDENT
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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