Organization · Type 2 NPI
Great Lakes Oral & Maxillofacial Surgery, P.a.
Oral and Maxillofacial Surgery (Dentist) · Stillwater, MN
NPI number
1508058322
Active
Practice location
2850 Curve Crest Blvd, Suite 130
Stillwater, MN 55082
Fax (651) 351-9333
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) Primary | 1223S0112X | 10762 (MN) |
Oral and Maxillofacial Surgery (Dentist): The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
Other oral and maxillofacial surgery (dentist) providers in Stillwater
About NPI 1508058322
Great Lakes Oral & Maxillofacial Surgery, P.a.'s National Provider Identifier is 1508058322, issued on Aug 15, 2007. The primary taxonomy on file is Oral and Maxillofacial Surgery (Dentist) (1223S0112X), and the practice location is in Stillwater, MN. The record was last updated on Oct 20, 2010.