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1376680009
GREGORY JOHN POVOLNY
BLAINE, MN
NPI
1376680009
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: MN 8811)
Enumeration Date
2007-01-31
Last Update Date
2007-07-08
Business Address
Dr. GREGORY JOHN POVOLNY D.D.S.
9120 BALTIMORE ST NE
BLAINE, MN 55449-4337
Phone number: 763-786-1560
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Mailing Address
Dr. GREGORY JOHN POVOLNY D.D.S.
3527 GLEN OAKS AVE
WHITE BEAR LAKE, MN 55110-5661
Phone number: 651-777-8427
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