institution
Great Lakes Oral & Maxillofacial Surgery, P.a.
Oral and Maxillofacial Surgery (Dentist) in Stillwater, Minnesota
NPI 1508058322

Great Lakes Oral & Maxillofacial Surgery, P.a. is a Oral and Maxillofacial Surgery (Dentist) based in Stillwater, MN and is specialized in Oral and Maxillofacial Surgery. Great Lakes Oral & Maxillofacial Surgery, P.a. practices in Stillwater, MN. The NPI Number for Great Lakes Oral & Maxillofacial Surgery, P.a. is 1508058322 and holds a License No. 10762 (Minnesota).

The current practice location address for Great Lakes Oral & Maxillofacial Surgery, P.a. is 2850 Curve Crest Blvd, Stillwater, MN and can be reached out via phone at 651-351-1010 and via fax at 651-351-9333. You can also correspond with Great Lakes Oral & Maxillofacial Surgery, P.a. through the mailing address at 2850 CURVE CREST BLVD, STILLWATER, MN - 55082 (mailing address contact number: 651-351-1010).

Location: 2850 Curve Crest Blvd, Stillwater, MN, 55082
institution
Provider Profile Details
NPI Number
1508058322
Provider Name
Great Lakes Oral & Maxillofacial Surgery, P.a.
Credential
Provider Entity Type
Organization
Address
2850 Curve Crest Blvd, Stillwater, MN, 55082
Phone Number
651-351-1010
Fax Number
651-351-9333
Provider Enumeration Date
08/15/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
33714200 01 WI MEDICAL ASSISTANCE
CC02769 05 MN
616822100 01 MN MEDICAL ASSISTANCE
88A90BR 01 MN BLUE CROSS BLUE SHIELD
institution
Provider Business Practice Location Address Details
Address
2850 Curve Crest Blvd
City
State
Zip
55082
Phone Number
651-351-1010
Fax Number
651-351-9333
person
Provider Business Mailing Address Details
Address
2850 Curve Crest Blvd
City
State
Zip
55082
Phone Number
651-351-1010
Fax Number
651-351-9333
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Oral and Maxillofacial Surgery
Taxonomy
License No.
10762 (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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