| Minnesota Maxillofacial And Oral Consultants | |
|
15600 36th Ave N Ste 100 Plymouth MN 55446-3369 | |
| (763) 559-7688 | |
| (763) 559-2237 |
| Full Name | Minnesota Maxillofacial And Oral Consultants |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 15600 36th Ave N Ste 100, Plymouth, Minnesota |
| Authorized Official Name and Position | Abdollah Rahimi (OWNER) |
| Authorized Official Contact | 7635597688 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Minnesota Maxillofacial And Oral Consultants 15600 36th Ave N Ste 100 Plymouth MN 55446-3369 Ph: (763) 559-7688 | Minnesota Maxillofacial And Oral Consultants 15600 36th Ave N Ste 100 Plymouth MN 55446-3369 Ph: (763) 559-7688 |
| NPI Number | 1417034661 |
|---|---|
| Provider Enumeration Date | 11/01/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417034661 | NPI | - | NPPES |
| 52D13MI | Other | MN | BLUE CROSS/BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | D10465 (Minnesota) | Primary |
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