OrganizationActive
Pdb, DDS, PA
NPI 1942809637 · Dental Clinic/Center · Maple Grove, MN
Pdb, DDS, PA is a Dental Clinic/Center organization in Maple Grove, MN (NPI 1942809637).
Provider details
- NPI number
- 1942809637
- Entity type
- Organization
- Primary specialty
- Dental Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Paul Boettner, Ceo(763) 476-6774
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Established profile(63/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
5 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
12736 Bass Lake Rd
Maple Grove, MN 55369-6307
Phone: (763) 559-2082
Street-level locationGet directions
Mailing address
1485 County Road 101 N
Plymouth, MN 55447-3053
Registry dates
- Enumerated
- 2020-10-22
- Last updated
- 2020-10-22
- Certified
- 2020-10-22
Frequently asked questions
- What is Pdb, DDS, PA's NPI number?
- Pdb, DDS, PA's National Provider Identifier (NPI) is 1942809637, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Pdb, DDS, PA?
- Pdb, DDS, PA is classified in the NPPES registry as Dental Clinic/Center (Ambulatory Health Care Facilities).
- Where is Pdb, DDS, PA located?
- Pdb, DDS, PA's practice location on file with NPPES is 12736 Bass Lake Rd, Maple Grove, MN 55369-6307.
- What is Pdb, DDS, PA's phone number?
- The practice phone number listed in the NPPES registry for Pdb, DDS, PA is (763) 559-2082.
- Who is the authorized official for Pdb, DDS, PA?
- The authorized official listed on Pdb, DDS, PA's NPPES record is Paul Boettner, Ceo. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Pdb, DDS, PA's NPI active?
- Yes — Pdb, DDS, PA's NPI (1942809637) is active in the NPPES registry as of the last update on 2020-10-22.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.