| Face And Jaw Surgeons Pc | |
|
2615 Elk Dr Suite 3 Minot ND 58701-1200 | |
| (701) 852-3421 | |
| (701) 838-1842 |
| Full Name | Face And Jaw Surgeons Pc |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 2615 Elk Dr, Minot, North Dakota |
| Authorized Official Name and Position | Joseph R Deatherage (DMD MD) |
| Authorized Official Contact | 7012587220 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Face And Jaw Surgeons Pc 2615 Elk Dr Suite 3 Minot ND 58701-1200 Ph: (701) 852-3421 | Face And Jaw Surgeons Pc 2615 Elk Dr Suite 3 Minot ND 58701-1200 Ph: (701) 852-3421 |
| NPI Number | 1104863505 |
|---|---|
| Provider Enumeration Date | 06/02/2006 |
| Last Update Date | 06/08/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104863505 | NPI | - | NPPES |
| 41328 | Medicaid | ND |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
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