| True North Oral Surgery And Implants Pllc | |
|
9950 Valley Creek Rd Suite 100 Woodbury MN 55125-4883 | |
| (651) 578-7000 | |
| (651) 578-0157 |
| Full Name | True North Oral Surgery And Implants Pllc |
|---|---|
| Speciality | Dentist |
| Location | 9950 Valley Creek Rd, Woodbury, Minnesota |
| Authorized Official Name and Position | Marshall Lloyd Wade (ORAL SURGEON/PRESIDENT) |
| Authorized Official Contact | 6515787000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| True North Oral Surgery And Implants Pllc 9950 Valley Creek Rd Suite 100 Woodbury MN 55125-4883 Ph: (651) 578-7000 | True North Oral Surgery And Implants Pllc 9950 Valley Creek Rd Suite 100 Woodbury MN 55125-4883 Ph: (651) 578-7000 |
| NPI Number | 1285179945 |
|---|---|
| Provider Enumeration Date | 01/04/2017 |
| Last Update Date | 04/12/2017 |
| Medicare PECOS PAC ID | 7214212810 |
|---|---|
| Medicare Enrollment ID | O20170322001301 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285179945 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | D9734 (Minnesota) | Primary |
| Provider Name | Paul A Vollmer |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1710955547 PECOS PAC ID: 5597708461 Enrollment ID: I20120125000905 |
| Provider Name | Travis A Johnson |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1841637295 PECOS PAC ID: 5597196717 Enrollment ID: I20200504000200 |
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