| Oral & Maxillofacial Surgery Specialists, Pa | |
|
490 S Maple St Ste 102 Waconia MN 55387-1762 | |
| (952) 442-5448 | |
| (952) 442-5496 |
| Full Name | Oral & Maxillofacial Surgery Specialists, Pa |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 490 S Maple St Ste 102, Waconia, 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 490 S Maple St Ste 102 Waconia MN 55387-1762 Ph: (952) 442-5448 |
| NPI Number | 1770694812 |
|---|---|
| Provider Enumeration Date | 08/31/2006 |
| Last Update Date | 07/29/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770694812 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
Kruckman Family Dentistry Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 141 Depot Dr, Waconia, MN 55387 Phone: 952-679-4461 | |
Modern Dental Professionals Mn Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 24 S Olive St, Waconia, MN 55387 Phone: 952-442-2518 Fax: 952-442-5040 | |
Regarding Dentistry, Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 732 Vista Blvd., Waconia, MN 55387 Phone: 952-442-2816 Fax: 952-442-2821 |