| Oral & Maxillofacial Surgery Specialists, Pa | |
| 
					1595 2nd Ave Ne Ste 120 Cambridge MN 55008-8071  | |
| (763) 757-2220 | |
| Not Available | 
| Full Name | Oral & Maxillofacial Surgery Specialists, Pa | 
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery | 
| Location | 1595 2nd Ave Ne Ste 120, Cambridge, Minnesota | 
| Authorized Official Name and Position | Kirby Charles Johnson (PRESIDENT) | 
| Authorized Official Contact | 6127889246 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Oral & Maxillofacial Surgery Specialists, Pa 550 County Road D Suite 12 New Brighton MN 55112 Ph: (651) 259-9902  | Oral & Maxillofacial Surgery Specialists, Pa 1595 2nd Ave Ne Ste 120 Cambridge MN 55008-8071 Ph: (763) 757-2220  | 
| NPI Number | 1508160060 | 
|---|---|
| Provider Enumeration Date | 12/27/2010 | 
| Last Update Date | 07/29/2014 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1508160060 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary | 
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