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

Pdb, DDS, PA

Organization Dental Clinic/Center · NPI 1942809637

Pdb, DDS, PA is a Dental Clinic/Center in Maple Grove, Minnesota. Registered with an NPI since 2020.

In the registry since
2020
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

12736 Bass Lake Rd
Maple Grove, MN 55369-6307
Phone: (763) 559-2082
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dental Clinic/Center (primary) Taxonomy 261QD0000X

Record details

NPI number1942809637
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Paul Boettner — Ceo · (763) 476-6774
NPI enumeratedOctober 22, 2020
Last updated in NPPESOctober 22, 2020
Certification dateOctober 22, 2020
Mailing address1485 County Road 101 N, Plymouth, MN 55447-3053

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