Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mdo Periodontics PA

Organization Periodontics · NPI 1558516369

Mdo Periodontics PA is a Periodontics in Sartell, Minnesota. Registered with an NPI since 2008.

In the registry since
2008
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1900 Kruchten Ct S Ste 101
Sartell, MN 56377-4730
Phone: (320) 240-9028
Fax: (320) 240-9048
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Periodontics (primary) Taxonomy 1223P0300X

Record details

NPI number1558516369
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Michelle Grundhoefer — Office Manager · (320) 240-9028
NPI enumeratedNovember 20, 2008
Last updated in NPPESNovember 20, 2008
Mailing address1900 Kruchten Ct S, Ste. 101, Sartell, MN 56377-4730