National Provider Identifier Database

NORTHSIDE MINNESOTA ORAL AND MAXILLOFACIAL SURGEONS PLLC
Oral and Maxillofacial Surgery

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.


Contact Information

NORTHSIDE MINNESOTA ORAL AND MAXILLOFACIAL SURGEONS, PLLC
11441 OSAGE ST NW
COON RAPIDS, MN55433-3677
Phone: 763-862-6442
Fax:
Website:
Specialty Taxonomy Code
* Oral and Maxillofacial Surgery 261QS0112X

* Indicates primary specialty

NPI Profile & details for NORTHSIDE MINNESOTA ORAL AND MAXILLOFACIAL SURGEONS, PLLC

NPI Number 1245809458
Legal business name
LBN
NORTHSIDE MINNESOTA ORAL AND MAXILLOFACIAL SURGEONS, PLLC
Authorized official MOHAMED EL DEEB - (OWNER)
Entity Organization
Organization subpart No
Enumeration date 06/22/2021
Last updated 06/22/2021 - About 5 years ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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