| Great Lakes Oral & Maxillofacial Surgery, P.a. | |
|
2850 Curve Crest Blvd Suite 130 Stillwater MN 55082 | |
| (651) 351-1010 | |
| (651) 351-9333 |
| Full Name | Great Lakes Oral & Maxillofacial Surgery, P.a. |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 2850 Curve Crest Blvd, Stillwater, Minnesota |
| Authorized Official Name and Position | Connie Louise Miller (PRACTICE MANAGER) |
| Authorized Official Contact | 6513511010 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Great Lakes Oral & Maxillofacial Surgery, P.a. 2850 Curve Crest Blvd Suite 130 Stillwater MN 55082 Ph: (651) 351-1010 | Great Lakes Oral & Maxillofacial Surgery, P.a. 2850 Curve Crest Blvd Suite 130 Stillwater MN 55082 Ph: (651) 351-1010 |
| NPI Number | 1508058322 |
|---|---|
| Provider Enumeration Date | 08/15/2007 |
| Last Update Date | 10/20/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508058322 | NPI | - | NPPES |
| 33714200 | Other | WI | MEDICAL ASSISTANCE |
| CC02769 | Medicaid | MN | |
| 616822100 | Other | MN | MEDICAL ASSISTANCE |
| 88A90BR | Other | MN | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 10762 (Minnesota) | Primary |
River Valley Endodontics Pa Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2600 Wild Pines Lane, Stillwater, MN 55082 Phone: 651-439-8085 Fax: 651-439-9705 | |
Oakridge Dental Center Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 13481 60th St N, Stillwater, MN 55082 Phone: 651-430-9990 Fax: 651-430-3448 | |
Lift Dental Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 124 2nd St S Ste 101, Stillwater, MN 55082 Phone: 651-439-4945 | |
Straight Smiles, Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 13961 60th St N, Stillwater, MN 55082 Phone: 651-351-7777 | |
Pdg, P.a. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 13961 60th St N, Stillwater, MN 55082 Phone: 651-439-2600 Fax: 651-439-2211 | |
The Dental Specialist Of Minnesota, Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 13961 60th St N, Stillwater, MN 55082 Phone: 651-760-3681 Fax: 651-760-3683 | |
Henseler Orthodontics Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2850 Curve Crest Blvd W, Stillwater, MN 55082 Phone: 651-439-8909 |