Southeastern Minnesota Oral & Maxillofacial Surgery Associates

NPI #1902099559 in Red Wing, Minnesota

Provider Information

NPI Number: 1902099559
Entity Type: Organization
Organization Name: Southeastern Minnesota Oral & Maxillofacial Surgery Associates
Primary Specialty: Clinic/Center - Oral and Maxillofacial Surgery
Enumeration Date: Aug 27, 2007
Last Updated: Aug 27, 2007

Practice Location

Address: 2835 S SERVICE DR
City: Red Wing
State: Minnesota
ZIP Code: 55066-1882
Phone: (651) 388-1515

Authorized Official

Name: DR. ROBERT A NUSTAD, DDS, MS
Title: VP, TREASURER
Phone: (651) 388-1515

Specialties & Taxonomy Codes

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

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