OrganizationActive
Pdg, PA
NPI 1104201284 · Dental Clinic/Center · Roseville, MN
Provider details
- NPI number
- 1104201284
- Entity type
- Organization
- Primary specialty
- Dental Clinic/CenterAmbulatory Health Care Facilities
- Parent organization
- Pdg, P.A.
- Organization subpart
- Yes
- Authorized official
- John Gulon, President(651) 633-0500
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Established profile(73/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
10 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1835 County Road C W
Suite 200
Roseville, MN 55113
Phone: (651) 209-7088
Fax: (651) 636-1118
Street-level locationGet directions
Mailing address
2200 County Road C W
Roseville, MN 55113-2550
Other names (DBA / former)
- Doing business as
- Facial Pain Center
- Doing business as
- Facial Pain Center
Registry dates
- Enumerated
- 2015-07-30
- Last updated
- 2020-10-28
- Certified
- 2020-10-28
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.