NPI 1184288979

Pdg, P.A.

Organisation Dental Clinic/Center Hermantown, MN

Practice location

Address: 4891 Miller Truck Hwy. Suite 100, Hermantown, MN 55811
Phone: (218) 722-7770
Fax: (218) 740-3234
Mailing address: 2200 County Road C W STE 2210, Roseville, MN 55113-2551

Authorised official

Name: Shannon Hesse
Title: Credentialing Specialists
Phone: (651) 746-2815

Registered specialties

Dental Clinic/Center Primary

Ambulatory Health Care Facilities Taxonomy 261QD0000X

Other Clinic/Center providers in Minnesota →

Registry record

NPI: 1184288979
Entity type: Organization
NPI issued: 26 Apr 2019
Record last updated: 28 Oct 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.