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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 Specialty Code Provider Type

Oral and Maxillofacial Surgery

261QS0112X
Indicates primary specialty

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

NPI # 1245809458
LBN Legal business name NORTHSIDE MINNESOTA ORAL AND MAXILLOFACIAL SURGEONS, PLLC
Authorized official MOHAMED EL DEEB - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 06/22/2021
Last updated 06/22/2021 - About 5 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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