Southdale Periodontics, Pllc

LBN: Southdale Periodontics, Pllc
Southdale Periodontics, Pllc is an health care organization with primary practice located at 6545 France Ave S Suite 190, Edina MN 55435-2131. The organization recently has only one registered license in Dental Providers / Periodontics, which is considered as the primary health care specialty. Southdale Periodontics, Pllc can be contacted via phone (952) 922-6949, or through Dylla, Russell Allen via phone (952) 922-6949.

Contact Information

Primary practice address
6545 France Ave S Suite 190 Edina MN 55435-2131
Phone: (952) 922-6949
Fax: (952) 922-9287
Website:
Map and Directions
Authorized official contact:
Name: Dylla, Russell Allen Doctor of Dental Surgery (DDS)
Phone: (952) 922-6949

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Periodontics 1223P0300X D12016 Minnesota

Profile Details

NPI number 1134547730
LBN Legal business name Southdale Periodontics, Pllc
DBA Doing business as
Authorized official Dylla, Russell Allen Doctor of Dental Surgery (DDS)
Entity Organization
Organization subpart 1 No
Enumeration date Apr 1st, 2014
Last updated Apr 1st, 2014 - about 12 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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