St Paul Oral Surgery and Dental Implants LLC
NPI #1124776687 in Mendota Heights, Minnesota
Provider Information
- NPI Number
- 1124776687
- Entity Type
- Organization
- Organization Name
- St Paul Oral Surgery and Dental Implants LLC
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- ST PAUL ORAL SURGERY AND DENTAL IMPLANTS LLC
- Primary Specialty
- Dentist - Oral and Maxillofacial Surgery
- Enumeration Date
- Mar 14, 2022
- Last Updated
- Mar 14, 2022
Practice Location
- Address
- 750 MAIN ST STE 200
- City
- Mendota Heights
- State
- Minnesota
- ZIP Code
- 55118-3767
- Phone
- (651) 451-1873
Authorized Official
- Name
- CELIA HAYES
- Title
- CREDENTIALING COORDINATOR
- Phone
- (217) 540-2100
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - Oral and Maxillofacial Surgery — Oral and Maxillofacial Surgery |
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