OrganizationActive
Family Periodontic Specialists, PLC
NPI 1487303889 · Periodontics · Maple Grove, MN
Provider details
- NPI number
- 1487303889
- Entity type
- Organization
- Primary specialty
- PeriodonticsDental Providers
- Parent organization
- Family Periodontic Specialists, PLC
- Organization subpart
- Yes
- Authorized official
- Celia Hayes, Credentialing Coordinator(217) 540-2100
Specialties & taxonomies
Dental Providers
Practice location
15785 95th Ave N
Maple Grove, MN 55369-4404
Phone: (763) 233-4141
Fax: (763) 420-3158
Approximate (ZIP-level) locationGet directions
Mailing address
15785 95th Ave N
Maple Grove, MN 55369-4404
Other names (DBA / former)
- Doing business as
- Metro Dentalcare Specialty Center Maple Grove - Periodontics
Registry dates
- Enumerated
- 2022-03-22
- Last updated
- 2022-03-22
- Certified
- 2022-03-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.