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PARK DENTAL
NPI 1285993345
Clinic/Center - Dental in Coon Rapids, MN

Active since May 10, 2012
3161 NORTHDALE BLVD NW, COON RAPIDS, MN 55433(763) 210-7096 Get Directions Write a Review

NPPES record last updated: October 28, 2020. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Table of Contents

  1. NPI Profile Information
  2. Primary Taxonomy
  3. Authorized Official
  4. Frequently Asked Questions
  • Organization
  • Clinic/Center
  • Dental

About PARK DENTAL

This page provides the complete NPI Profile along with additional information for Park Dental, a provider established in Coon Rapids, Minnesota operating as a Clinic/center, focusing in dental . The healthcare provider is registered in the NPI registry with number 1285993345 assigned on May 2012. The practitioner's primary taxonomy code is 261QD0000X. The provider is registered as an organization and their NPI record was last updated 6 years ago. The provider's is doing business as Park Dental. The authorized official of this NPI record is Dr. John Gulon Dds (President)

NPI
1285993345 Verify this NPI
Provider Legal Name
PDG, P.A.
Other Organization Name
PARK DENTAL
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
3161 NORTHDALE BLVD NW COON RAPIDS, MN 55433
Location Phone
(763) 210-7096
Mailing Address
2200 COUNTY ROAD C W SUITE 2210 ROSEVILLE, MN 55113
Mailing Phone
(651) 633-0500
Mailing Fax
(651) 636-6894
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
05-10-2012
Last Update Date
10-28-2020
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center Dental

Taxonomy Code
261QD0000X
Type
Ambulatory Health Care Facilities

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

DR. JOHN GULON DDS

Authorized Official Title
PRESIDENT
Authorized Official Phone
(651) 633-0500

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Frequently Asked Questions

What is PDG, P.A.'s NPI number?

The NPI number assigned to this healthcare provider is 1285993345, enumerated as an "organization" on May 10, 2012.

Where is the provider located?

The provider is located at 3161 NORTHDALE BLVD NW COON RAPIDS, MN 55433 and the phone number is (763) 210-7096.

What is the provider's specialty?

Clinic/Center with taxonomy code 261QD0000X and a focus in Dental.