institution
Minnesota Maxillofacial And Oral Consultants
Oral and Maxillofacial Surgery (Dentist) in Plymouth, Minnesota
NPI 1417034661

Minnesota Maxillofacial And Oral Consultants is a Oral and Maxillofacial Surgery (Dentist) based in Plymouth, MN and is specialized in Oral and Maxillofacial Surgery. Minnesota Maxillofacial And Oral Consultants practices in Plymouth, MN. The NPI Number for Minnesota Maxillofacial And Oral Consultants is 1417034661 and holds a License No. D10465 (Minnesota).

The current practice location address for Minnesota Maxillofacial And Oral Consultants is 15600 36Th Ave N Ste 100, Plymouth, MN and can be reached out via phone at 763-559-7688 and via fax at 763-559-2237.

Location: 15600 36Th Ave N Ste 100, Plymouth, MN, 55446-3369
institution
Provider Profile Details
NPI Number
1417034661
Provider Name
Minnesota Maxillofacial And Oral Consultants
Credential
Provider Entity Type
Organization
Address
15600 36Th Ave N Ste 100, Plymouth, MN, 55446-3369
Phone Number
763-559-7688
Fax Number
763-559-2237
Provider Enumeration Date
11/01/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
52D13MI 01 MN BLUE CROSS/BLUE SHIELD
institution
Provider Business Practice Location Address Details
Address
15600 36Th Ave N Ste 100
City
State
Zip
55446-3369
Phone Number
763-559-7688
Fax Number
763-559-2237
person
Provider Business Mailing Address Details
Address
15600 36Th Ave N Ste 100
City
State
Zip
55446-3369
Phone Number
763-559-7688
Fax Number
763-559-2237
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Oral and Maxillofacial Surgery
Taxonomy
License No.
D10465 (Minnesota)
Definition
The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
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