| Affiliated Oral And Maxillofacial Surgeons P.a. | |
|
11601 Minnetonka Mills Rd Minnetonka MN 55305-5161 | |
| (952) 935-8420 | |
| (952) 935-0147 |
| Full Name | Affiliated Oral And Maxillofacial Surgeons P.a. |
|---|---|
| Speciality | Dentist |
| Location | 11601 Minnetonka Mills Rd, Minnetonka, Minnesota |
| Authorized Official Name and Position | James Carl Block (OWNER/PRESIDENT) |
| Authorized Official Contact | 9529358420 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Affiliated Oral And Maxillofacial Surgeons P.a. 11601 Minnetonka Mills Rd Minnetonka MN 55305-5161 Ph: (952) 935-8420 | Affiliated Oral And Maxillofacial Surgeons P.a. 11601 Minnetonka Mills Rd Minnetonka MN 55305-5161 Ph: (952) 935-8420 |
| NPI Number | 1679620801 |
|---|---|
| Provider Enumeration Date | 01/03/2007 |
| Last Update Date | 12/14/2015 |
| Medicare PECOS PAC ID | 9335322957 |
|---|---|
| Medicare Enrollment ID | O20110319000050 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679620801 | NPI | - | NPPES |
| 315223500 | Medicaid | MN | |
| 352518000 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
| Provider Name | James C Block |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1841337953 PECOS PAC ID: 4880877406 Enrollment ID: I20110319000057 |
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