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

Minneapolis-St Paul Periodontics

Organization Periodontics · NPI 1013216811

Minneapolis-St Paul Periodontics is a Periodontics in Fridley, Minnesota. Licensed in Minnesota. Registered with an NPI since 2011.

Licensed in
MN
In the registry since
2011
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Practice location Address checks out

1109 E Moore Lake Dr
Fridley, MN 55432
Phone: (651) 439-2600
Fax: (651) 439-2211
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Periodontics (primary) Taxonomy 1223P0300X · Licence D11710 (MN)

Record details

NPI number1013216811
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationSt Croix Valley Dental
Authorized official Doug Wolff — Owner · (651) 439-2600
NPI enumeratedMarch 18, 2011
Last updated in NPPESMarch 18, 2011
Mailing address1109 East Moore Lake Drive, Fridley, MN 55432

Other providers in Fridley