Southeastern Minnesota Oral & Maxillofacial Surgery Associates

NPI #1659492312 in Owatonna, Minnesota

Provider Information

NPI Number: 1659492312
Entity Type: Organization
Organization Name: Southeastern Minnesota Oral & Maxillofacial Surgery Associates
Primary Specialty: Clinic/Center - Oral and Maxillofacial Surgery
Enumeration Date: Apr 2, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: 605 HILLCREST AVE STE 130
City: Owatonna
State: Minnesota
ZIP Code: 55060-3680
Phone: (507) 451-0290

Authorized Official

Name: DR. ROBERT A NUSTAD, DDS, MS
Title: VP, TREASURER
Phone: (507) 451-0290

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Oral and Maxillofacial Surgery — Oral and Maxillofacial Surgery	261QS0112X	Primary

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