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Contact Information

MINNESOTA ORAL AND MAXILLOFACIAL SURGEONS
1511 NORTHWAY DRIVE
SUITE 103
SAINT CLOUD, MN56303
 Phone: 320-240-0927
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dentist

122300000X
Indicates primary specialty

NPI Profile & details for MINNESOTA ORAL AND MAXILLOFACIAL SURGEONS

NPI Number 1154519338
LBN Legal business name MINNESOTA ORAL AND MAXILLOFACIAL SURGEONS
Authorized official MOHAMED EL DEEB - (OWNER/PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 10/12/2007
Last updated 10/01/2008 - About 18 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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