| Dr Mark R Omlie, DDS-MD | |
|
7373 France Ave S, Suite 602, Edina, MN 55435-4534 | |
| (952) 835-5003 | |
| (952) 835-9598 |
| Full Name | Dr Mark R Omlie |
|---|---|
| Gender | Male |
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 7373 France Ave S, Edina, Minnesota |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942272489 | NPI | - | NPPES |
| 130740M | Other | MN | BCBS NUMBER |
| 86-14849 | Other | MN | MEDICA NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | DO8081 (Minnesota) | Primary |
| Entity Name | Oral And Maxillofacial Surgical Consultants Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1316165012 PECOS PAC ID: 2961489844 Enrollment ID: O20040630000218 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Mark R Omlie, DDS-MD 7373 France Ave S, Suite 602, Edina, MN 55435-4534 Ph: (952) 835-5003 | Dr Mark R Omlie, DDS-MD 7373 France Ave S, Suite 602, Edina, MN 55435-4534 Ph: (952) 835-5003 |
Steven T Maroney, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 5100 Eden Ave, #209, Edina, MN 55436 Phone: 952-929-0641 Fax: 952-929-1802 | |
Dr. Michele Ann Reynolds, D.D.S.,M.S. Dentist Medicare: Medicare Enrolled Practice Location: 6545 France Ave S, Suite 665 Southdale Medical Building, Edina, MN 55435 Phone: 952-927-8694 | |
Dr. Janet Amy Zingale, D.D.S. Dentist Medicare: Medicare Enrolled Practice Location: 3930 Sunnyside Rd, Edina, MN 55424 Phone: 952-929-9131 | |
Dr. David John Clay, DDS MS Dentist Medicare: Not Enrolled in Medicare Practice Location: 6545 France Ave S, Suite 680, Edina, MN 55435 Phone: 952-922-5326 Fax: 952-922-5367 | |
Robert Luther Bodin, Dentist Medicare: Not Enrolled in Medicare Practice Location: 5100 Eden Ave, Edina, MN 55436 Phone: 952-929-0641 | |
Dr. Mary Elizabeth Johnson, D.D.S. Dentist Medicare: Medicare Enrolled Practice Location: 6545 France Ave S, Suite 665, Edina, MN 55435 Phone: 952-927-8694 Fax: 952-927-8695 | |
Dr. Craig Freeman, DDS Dentist Medicare: Medicare Enrolled Practice Location: 7373 France Ave S Ste 500, Edina, MN 55435 Phone: 952-831-2800 |