PDG, P.a.
Organization Active NPI Dental Clinic/Center · Roberts, WI
NPI 1639508153 · NPPES record last updated Oct 28, 2020
Key facts
- NPI
- 1639508153
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Dental Clinic/Center 261QD0000X
- Legal business name
- PDG, P.A.
- Practice address
- 501 Cherry LN
Roberts, WI 54023-9731 - Phone
- (715) 749-9111
- Fax
- (715) 749-9222
- NPI assigned
- Nov 5, 2013
- Organization subpart
- No
Authorized official
- Name
- Dr. John Gulon
- Title
- President
- Phone
- (651) 633-0500
Corporate family (same tax ID) 2
National Provider Directory
- Tax ID family
- Casey Luke Newton
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Clinic/Center | 261QD0000X | Yes |
Addresses
Primary practice location
501 Cherry LN
Roberts, WI 54023-9731
Mailing address
2200 County Road C W
Suite 2210
Roseville, MN 55113-2550
Phone (651) 633-0500
Other names
- Park Dental
Other providers in Roberts, WI
- Julie Ann Madaris
- Ajaypal Singh Mann
- Nan Reinhardt, Otr/L & Assoc, LLC
- Angela A Nelson
- Brittany Ann Pace
- Reflective Roots Psychotherapy & Healing, LLC
- Sandcastle Recovery LLC
- Marrie J Simpson
- Jessica Sperstad
- St Croix Valley Dental PLLC
All providers in Roberts, WI · Dental Clinic/Center in Wisconsin
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.