Orthodontic Specialists of Minnesota, P.L.L.C.
Organization Active NPI Orthodontics and Dentofacial Orthopedics Dentistry · Fridley, MN
NPI 1306338553 · NPPES record last updated Oct 28, 2020
Key facts
- NPI
- 1306338553
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X
- Legal business name
- ORTHODONTIC SPECIALISTS OF MINNESOTA, P.L.L.C.
- Practice address
- 1109 Moore Lake Dr E
Fridley, MN 55432 - Phone
- (763) 572-2224
- NPI assigned
- Jun 4, 2018
- Organization subpart
- No
Authorized official
- Name
- Dr. John Gulon, DDS
- Title
- President
- Phone
- (651) 746-2815
Corporate family (same tax ID) 12
National Provider Directory
- Tax ID family
- Orthodontic Specialists of Minnesota PLLC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry |
1223X0400X | Yes |
Addresses
Primary practice location
1109 Moore Lake Dr E
Fridley, MN 55432
Mailing address
2200 County Road C W Ste 2210
Roseville, MN 55113-2551
Phone (651) 746-2815
Other names
- The Dental Specialists-Orthodontics
Other providers in Fridley, MN
- Hanan Hashim Omar
- Mohamed Ahmed Omar
- Ontime Care LLC
- Optimum Healthcare Services LLC
- Optometric Eye Care Centers, P.a.
- Elvis E Osagie
- Abyan Jama Osman
- Aziza A Osman
- Fatuma A Osman
- Hibaq Mohamed Osman
All providers in Fridley, MN · Orthodontics and Dentofacial Orthopedics Dentistry in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 28, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.