Oral & Maxillofacial Surgery Specialists, PA
NPI #1902917057 in Maple Grove, Minnesota
Provider Information
- NPI Number
- 1902917057
- Entity Type
- Organization
- Organization Name
- Oral & Maxillofacial Surgery Specialists, PA
- Primary Specialty
- Dentist - Oral and Maxillofacial Surgery
- Enumeration Date
- Aug 31, 2006
- Last Updated
- Jul 29, 2014
Practice Location
- Address
- 13784 83RD WAY N STE 92
- City
- Maple Grove
- State
- Minnesota
- ZIP Code
- 55369-7191
- Phone
- (763) 494-8825
Authorized Official
- Name
- KIRBY CHARLES JOHNSON, DDS
- Title
- PRESIDENT
- Phone
- (612) 788-9246
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - Oral and Maxillofacial Surgery — Oral and Maxillofacial Surgery |
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